REGENERATIVE ORTHOPEDICS & SPORTS MEDICINE OF BOULDER CO PLLC (NPI# 1497261523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497261523 |
| Entity Type | Organization |
| Organization Name | REGENERATIVE ORTHOPEDICS & SPORTS MEDICINE OF BOULDER CO PLLC |
| Other Organization Name | REGENERATIVE ORTHOPEDICS & SPORTS MEDICINE |
| Practice Address |
350 Broadway St Ste 202 Boulder CO 80305-3338 |
| Mailing Address |
600 Pennsylvania Ave Se Ste 202 Washington DC 20003-4425 |
| Practice Telephone | 2026817671 |
| Practice Fax Number | 8446817671 |
| Mailing Telephone | 2026817671 |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2018-01-03 |
| Authorized Official Name | DONA BOWIE (OFFICE MANAGER) |
| Authorized Official Telephone | 2026817671 |
| Is Organization Subpart | Y |
| Parent Organization Name | REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
00041636 | CO | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Regenerative Orthopedics & Sports Medicine | Other Name - Individual/Organization |
| Street Address |
350 BROADWAY ST STE 202 |
| City | BOULDER |
| State | CO |
| Zip Code | 80305-3338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437130424 | Timothy Joseph Mazzola | Family Medicine | 350 Broadway St Ste 202, Boulder, CO 80305 | 2005-11-08 |
| 1053751032 | Derek Garn Rodeback | Physical Medicine & Rehabilitation | 350 Broadway St Ste 202, Boulder, CO 80305 | 2013-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538698923 | Carian Mclean | Registered Nurse | 1013 Berea Dr, Boulder, CO 80305 | 2017-06-08 |
| 1548629439 | Kimberly Norquist | Dental Hygienist | 661 S. Broadway St, Boulder, CO 80305 | 2016-02-19 |
| 1871981266 | Kathleen Anne Stone | Registered Nurse | 3680 Silver Plume Lane, Boulder, CO 80305 | 2015-01-07 |
| 1104235779 | Joyce Larson | Marriage & Family Therapist | 1190 S Lashley Ln, Boulder, CO 80305 | 2014-08-07 |
| 1982035788 | Virginia Pleasants Vandenbergh | Counselor | 4760 Ludlow St, Boulder, CO 80305 | 2013-12-03 |
| 1790992550 | Jasjit Singh Gill | Pharmacist | The Apothecary Pharmacy - University of Colorado, 350 Broadway Ste. 50, Boulder, CO 80305 | 2007-05-17 |
| 1477768299 | Stephen W Laycock | Dentist | 4150 Darley Ave., Suite 7, Boulder, CO 80305 | 2007-05-14 |
| 1871614560 | Steven Leslie Buffer | Dentist | 385 Broadway St, Boulder, CO 80305 | 2007-04-02 |
| 1801927793 | Jeffrey Dann | Acupuncturist | 3400 Table Mesa Drive, Ste. 205, Boulder, CO 80305 | 2007-03-09 |
| 1235292145 | Pharmaca Integrative Pharmacy | Exclusive Provider Organization | 645 South Boulder, Boulder, CO 80305 | 2006-12-19 |
| Find all providers in zip 80305 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750763017 | Ryan Jahn | Orthopaedic Surgery | 2150 Stadium Dr 2nd Floor, Boulder, CO 80309-1029 | 2015-06-23 |
| 1063048486 | Jennah Durham | Orthopaedic Surgery | 2150 Stadium Dr 2nd Floor, Boulder, CO 80309-2550 | 2020-03-17 |
| 1720446222 | University Physicians Incorporated | Orthopaedic Surgery | 2150 Stadium Dr, 2nd Floor, Boulder, CO 80309 | 2016-01-29 |
| 1811371669 | Adam Lindsay | Orthopaedic Surgery | 2150 Stadium Dr 2nd Floor, Boulder, CO 80309-1029 | 2015-07-10 |
| 1235308982 | Boulder Institute for Sports Medicine, P.C. | Orthopaedic Surgery | 3000 Center Green Dr, Suite 150, Boulder, CO 80301-2364 | 2008-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884057 | Scl Health Medical Group - Denver, LLC | Orthopaedic Surgery | 1830 N Franklin St Ste 340, Denver, CO 80218-1128 | 2020-09-02 |
| 1700498797 | Colorado Sports Medicine and Orthopaedics | Orthopaedic Surgery | 4500 E 9th Ave Ste 420, Denver, CO 80220-3931 | 2020-08-20 |
| 1033668322 | University Physicians, Incorporated | Orthopaedic Surgery | 10103 Ridgegate Pkwy Ste 100, Cu Sports Medicine Sdh Lonetree, Lone Tree, CO 80124-5520 | 2016-09-27 |
| 1518353218 | Valley View Hospital Association | Orthopaedic Surgery | 1830 Blake Ave Ste 207, Glenwood Spgs, CO 81601-4261 | 2015-04-09 |
| 1326276783 | Thomas P Moore Md Phd PC | Orthopaedic Surgery | 32 Crested Mt. Way, Mt. Crested Butte, CO 81225 | 2009-06-24 |
| 1396919858 | Stephanie Watson Mayer | Orthopaedic Surgery | 13123 E 16th Ave # B060, Aurora, CO 80045-7106 | 2008-04-16 |
| 1689889966 | Orthopedic Surgery & Sports Medicine Specialist | Orthopaedic Surgery | 9141 Grant St Ste 10, Thornton, CO 80229-4374 | 2007-05-11 |
| 1023117850 | Rocky Mountain Trauma Services Proff LLC | Orthopaedic Surgery | 13918 E Mississippi Ave, Suite 473, Aurora, CO 80012 | 2006-09-21 |
| 1215045133 | Andrew W Parker | Orthopaedic Surgery | 4700 E.hale Pkwy, Ste 550, Denver, CO 80220-4053 | 2006-08-29 |
| 1720099187 | Michael P Wertz | Orthopaedic Surgery | 1032 S 88th St, Louisville, CO 80027-4644 | 2006-08-11 |
| 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.