METRO COMMUNITY PROVIDER NETWORK, INC. (NPI# 1093075491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093075491 |
| Entity Type | Organization |
| Organization Name | METRO COMMUNITY PROVIDER NETWORK, INC. |
| Other Organization Name | STRIDE CHC - MOBILE HEALTH UNIT |
| Practice Address |
11005 Ralston Rd Arvada CO 80004-4551 |
| Mailing Address |
2255 S Oneida St Denver CO 80224-2522 |
| Practice Telephone | 3033606276 |
| Practice Fax Number | 3037626552 |
| Mailing Telephone | 3037611977 |
| Mailing Fax Number | 3037612787 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | MR. BEN R. WIEDERHOLT (PRESIDENT AND CEO) |
| Authorized Official Telephone | 3037611977 |
| Is Organization Subpart | Y |
| Parent Organization Name | METRO COMMUNITY PROVIDER NETWORK, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
CO | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| MCPN Dental Van | Other Name - Individual/Organization |
| STRIDE CHC - Mobile Health Unit | Doing Business As Name - Organization |
| STRIDE CHC-Dental Van | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014805 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-13 |
| 1033755392 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 W 2nd Pl # 200, Lakewood, CO 80228-1506 | 2019-11-21 |
| 1952853772 | Metro Community Provider Network, Inc. | Clinic/Center | 6303 Wadsworth Bypas, Arvada, CO 80003 | 2016-10-27 |
| 1679931646 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 South Teller Street, Lakewood, CO 80235-2014 | 2016-02-05 |
| 1558727883 | Metro Community Provider Network, Inc. | Clinic/Center | 10680 Del Mar Parkway, Aurora, CO 80010-4011 | 2015-12-31 |
| 1649605536 | Metro Community Provider Network, Inc. | Clinic/Center | 1537 Alton Street, Aurora, CO 80010-1712 | 2013-09-10 |
| 1811333842 | Metro Community Provider Network, Inc. | Clinic/Center | 1666 Elmira Street, Aurora, CO 80110-2122 | 2013-05-16 |
| 1184961492 | Metro Community Provider Network, Inc. | Clinic/Center | 7495 West 29th Avenue, Wheat Ridge, CO 80033-8002 | 2013-01-07 |
| 1568707776 | Metro Community Provider Network, Inc. | Clinic/Center | 15501 East 13th Avenue, Aurora, CO 80011-7203 | 2012-11-29 |
| 1114213972 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 West 2nd Place, Lakewood, CO 80228-1506 | 2011-06-21 |
| Street Address |
11005 RALSTON RD |
| City | ARVADA |
| State | CO |
| Zip Code | 80004-4551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043252968 | Ruth Finley Knight | Physician Assistant | 11005 Ralston Rd, Suite 100g, Arvada, CO 80004-4551 | 2006-06-12 |
| 1891192001 | Lindsey Hagerty | Dental Hygienist | 11005 Ralston Rd, Ste. 210, Arvada, CO 80004-4551 | 2014-12-03 |
| 1396094082 | Meghan Cito | Social Worker | 11005 Ralston Rd, Arvada, CO 80004 | 2012-09-10 |
| 1417277542 | Dolores Anne Sangiuliano | Registered Nurse | 11005 Ralston Rd, Arvada, CO 80004-4551 | 2010-06-11 |
| 1215254974 | Tammy Thi Do | Dental Hygienist | 11005 Ralston Rd, Suite 202, Arvada, CO 80004-4551 | 2010-04-21 |
| 1144469784 | Sung W Cho | Dentist | 11005 Ralston Rd, Suite 202, Arvada, CO 80004-4551 | 2009-02-05 |
| 1275653917 | Larry D Ward | Dentist | 11005 Ralston Rd, Arvada, CO 80004-4551 | 2007-03-29 |
| 1851432405 | Kelly Laing-hall | Licensed Practical Nurse | 11005 Ralston Rd, Suite 102, Arvada, CO 80004-4551 | 2007-02-08 |
| 1275672461 | Diane Barnes | Nurse Practitioner | 11005 Ralston Rd, Suite 100 - G, Arvada, CO 80004-4551 | 2007-02-05 |
| 1366543902 | Grady Michael Holder | Family Medicine | 11005 Ralston Rd, Suite 100g, Arvada, CO 80004-4551 | 2006-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326503194 | Flynn Behavior Associates | Behavioral Analyst | 13185 W 62nd Place, Arvada, CO 80004 | 2019-02-06 |
| 1124543384 | Zoe Denver Nelson | Counselor | 9850 W 59th Pl, Arvada, CO 80004 | 2017-08-09 |
| 1982134573 | Cynthia Jean Keefover | Physical Therapy Assistant | 6625 Union St, Arvada, CO 80004 | 2017-06-15 |
| 1235680257 | Uma Sitaula | Nurse Practitioner | 12650 W 64th Ave Unit E 105, Arvada, CO 80004 | 2016-10-14 |
| 1124494091 | Alan Ross Hofman | Physical Therapist | 5945 Ward Rd Ste 110, Arvada, CO 80004 | 2015-08-14 |
| 1770969917 | Jennifer Lynn Johnson | Day Training/Habilitation Specialist | 6725 Yarrow St., Arvada, CO 80004 | 2015-08-10 |
| 1649680414 | Johanna Meister | Community Health Worker | 7603 Robinson Way, Arvada, CO 80004 | 2014-05-02 |
| 1922346915 | Ashley L Saylor | Chiropractor | 10050 Ralston Rd. Suite E, Arvada, CO 80004 | 2013-01-25 |
| 1225382906 | Alison Schut | Nurse Practitioner | 12650 W 64th Ave Ste E501, Arvada, CO 80004 | 2012-11-02 |
| 1881984102 | Green Leaf Massage Center. LLC | Health Maintenance Organization | 11890 W.64th Avenue, Arvada, CO 80004 | 2011-04-08 |
| Find all providers in zip 80004 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376701300 | Metro Community Provider Network, Inc. | Clinic/Center | 11005 Ralston Road, Suite 100-g, Arvada, CO 80004-4551 | 2008-05-27 |
| 1588201180 | Metro Community Provider Network, Inc. | Clinic/Center | 11005 Ralston Rd Ste 202, Arvada, CO 80004-4551 | 2019-12-03 |
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|---|---|---|---|---|
| 1972118073 | Sunrise Community Health | Clinic/Center | 2880 Monroe Ave, Loveland, CO 80538-3274 | 2020-09-15 |
| 1538772892 | Valley-wide Health Systems, Inc. | Clinic/Center | 204 Carson Ave, Alamosa, CO 81101-2342 | 2020-08-26 |
| 1225640931 | Valley-wide Health Systems, Inc. | Clinic/Center | 1215 Main St Ste B, Canon City, CO 81212-3505 | 2020-08-24 |
| 1568073229 | Mountain Family Health Centers | Clinic/Center | 2270 Highway 133, Carbondale, CO 81623-9271 | 2020-08-14 |
| 1912515735 | Peak Vista Community Health Centers | Clinic/Center | 423 E Cucharras St Ste 2, Colorado Springs, CO 80903-3609 | 2020-07-17 |
| 1861014805 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-13 |
| 1548897648 | Plan De Salud Del Valle, Inc | Clinic/Center | 709 E Riverview Ave # 201, Fort Morgan, CO 80701-3263 | 2020-03-26 |
| 1093345886 | Marillac Clinic, Inc. | Clinic/Center | 550 Warrior Way, Grand Junction, CO 81504-6401 | 2020-01-21 |
| 1134766553 | Plan De Salud Del Valle, Inc | Clinic/Center | 562 Sable Blvd Ste 100, Aurora, CO 80011-0809 | 2019-12-04 |
| 1033755392 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 W 2nd Pl # 200, Lakewood, CO 80228-1506 | 2019-11-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.