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DAKOTA RIDGE FAMILY MEDICINE PC NPI 1720043888


NPI Information

NPI: 1720043888
Provider Name: DAKOTA RIDGE FAMILY MEDICINE, PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 06D0670881

Address:
2995 BASELINE RD
SUITE 210
BOULDER, CO
ZIP 80303
Phone: (303) 443-2544
Get Directions

DAKOTA RIDGE FAMILY MEDICINE, PC is a family medicine in Boulder, CO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DAKOTA RIDGE FAMILY MEDICINE, PC NPI is 1720043888. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2995 BASELINE RD
SUITE 210
BOULDER, CO
ZIP 80303-318
Phone: (303) 443-2544
Fax: (303) 443-6476

The provider's authorized official is Vickie E Mccay .
The authorized official title is Office Manager and has the following contact phone number (303) 443-2544.

The CLIA number assigned to this NPI record is 06D0670881 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/19/2006 and was last updated on 10/25/2007.


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
1207Q00000XFamily MedicineYes

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
183482270MEDICAIDCOLORADO
2C9608MEDICARE PINCOLORADO

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: 4/28/2024

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