Organization · Type 2 NPI

Optumcare Colorado Medical Group LLC

General Practice Physician · Monument, CO

NPI number 1346632684 Active

Practice location

15909 Jackson Creek Pkwy
Monument, CO 80132-8693

Call (719) 488-9933 Map

Fax (719) 488-7396

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
Pediatrics Physician	208000000X	None listed
General Practice Physician Primary	208D00000X	None listed
Non-Pharmacy Dispensing Site	332900000X	None listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

11 other providers at this address

Other general practice physician providers in Monument

See all in Monument →

NPI record

NPI: 1346632684
Entity type: Organization (Type 2)
Issued: Feb 24, 2015
Last updated: Aug 20, 2024
Status: Active

Other names

<unavail>
Optum Colorado Springs - Monument · doing business as
Colorado Springs Health Partners LLC · former legal business name
Davita Medical Group Colorado Springs LLC · former legal business name
Optumcare Colorado Springs LLC · former legal business name

Authorized official

Emily Castillo
Associate Director Credentialing
(702) 579-3253

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1346632684

Optumcare Colorado Medical Group LLC's National Provider Identifier is 1346632684, issued on Feb 24, 2015. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Monument, CO. The record was last updated on Aug 20, 2024.