OPTUMCARE COLORADO SPRINGS LLC NPI 1407252828

NPI Information

NPI: 1407252828
Provider Name: OPTUMCARE COLORADO SPRINGS, LLC

Former Legal Business Name: DAVITA MEDICAL GROUP

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
2 S CASCADE AVE
STE 140
COLORADO SPRINGS, CO
ZIP 80903
Phone: (719) 538-2900
Get Directions

OPTUMCARE COLORADO SPRINGS, LLC is a general practice in Colorado Springs, CO. OPTUMCARE COLORADO SPRINGS, LLC NPI is 1407252828. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Davita Medical Group.

The provider's business location address is:

2 S CASCADE AVE
STE 140
COLORADO SPRINGS, CO
ZIP 80903
Phone: (719) 538-2900
Fax: (719) 538-2987

The provider's authorized official is Dorothy W Dolve .
The authorized official title is Director and has the following contact phone number (719) 538-2980.

The enumeration date for this NPI number is 11/12/2014 and was last updated on 2/10/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				No
2	208D00000X	General Practice			COLORADO	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	06085288	MEDICAID	COLORADO

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

NPI Synchronization or Removal

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