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COLORADO SPINE INSTITUTE PROFESSIONAL LLC NPI 1801208236


NPI Information

NPI: 1801208236
Provider Name: COLORADO SPINE INSTITUTE PROFESSIONAL LLC
Classification: Orthopaedic Surgery - 207XS0117X
Entity Type: Organization

Specialization: Orthopaedic Surgery of the Spine

CLIA Number: 06D2096520

Address:
4795 LARIMER PKWY
JOHNSTOWN, CO
ZIP 80534
Phone: (970) 342-2220
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COLORADO SPINE INSTITUTE PROFESSIONAL LLC is an orthopaedic surgery of the spine orthopaedic surgery in Johnstown, CO. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. COLORADO SPINE INSTITUTE PROFESSIONAL LLC NPI is 1801208236. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4795 LARIMER PKWY
JOHNSTOWN, CO
ZIP 80534-021
Phone: (970) 342-2220
Fax: (970) 342-2221

The provider's authorized official is Edward Jeffrey Donner .
The authorized official title is Owner and has the following contact phone number (970) 342-2220.

The CLIA number assigned to this NPI record is 06D2096520 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2014 and was last updated on 3/7/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the Spine30264COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B7728MEDICARE PINCOLORADO
2B41729MEDICARE UPINCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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