METRO COMMUNITY PROVIDER NETWORK, INC. (NPI# 1861014805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861014805 |
| Entity Type | Organization |
| Organization Name | METRO COMMUNITY PROVIDER NETWORK, INC. |
| Practice Address |
3595 S Teller St Fl 4 Lakewood CO 80235-2014 |
| Mailing Address |
2255 S Oneida St Denver CO 80224-2522 |
| Practice Telephone | 3033606276 |
| Practice Fax Number | 3032747093 |
| Mailing Telephone | 3033606276 |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2020-05-13 |
| Authorized Official Name | BEN WIEDERHOLT (PRESIDENT & 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) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| STRIDE CHC - Jefferson Plaza Behavioral Health at Jefferson Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1558657312 | Metro Community Provider Network, Inc. | Clinic/Center | 791 Chambers Rd Ste 220, Aurora, CO 80011-7112 | 2011-06-21 |
| Street Address |
3595 S TELLER ST FL 4 |
| City | LAKEWOOD |
| State | CO |
| Zip Code | 80235-2014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447873773 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295244051 | Nicole Gan | Behavioral Analyst | 7220w. Jefferson Ave Suite 202, Lakewood, CA 80235 | 2017-09-25 |
| 1336684059 | Preferred Homecare Infusion, LLC | Durable Medical Equipment & Medical Supplies | 6900 W Jefferson Ave Ste 130, Lakewood, CO 80235 | 2017-01-04 |
| 1457501637 | Patrick John Rydell | Speech-Language Pathologist | 3636 S. Independence St., Lakewood, CO 80235 | 2008-09-24 |
| 1164631644 | Carole M. Emanuel | Dentist | 7373 West Jefferson Ave., Suite #304, Lakewood, CO 80235 | 2007-05-22 |
| 1235259680 | Christopher David Elson | Dentist | 7373 W. Jefferson Ave #403, Lakewood, CO 80235 | 2007-03-30 |
| 1750420840 | Kelly Z Crim | Counselor | 3900 S. Wadsworth Blvd Suite 360, Lakewood, CO 80235 | 2007-02-05 |
| 1750469714 | Paul Henry Arendt | Dentist | 7373 W Jefferson Ave #304, Lakewood, CO 80235 | 2006-11-01 |
| 1750491544 | Sharon Diane Hilderbrant | Psychologist | 7220 W Jefferson Ave, Suite 307, Lakewood, CO 80235 | 2006-08-30 |
| 1346766466 | Jayden Brooke Cornejo | Behavior Technician | 7220 W Jefferson Ave Ste 202, Lakewood, CO 80235 | 2017-08-21 |
| 1114478575 | Brennan Bonati | Dentist | 7373 W Jefferson Ave, Lakewood, CO 80235 | 2016-10-20 |
| Find all providers in zip 80235 | ||||
| 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 |
|---|---|---|---|---|
| 1033755392 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 W 2nd Pl # 200, Lakewood, CO 80228-1506 | 2019-11-21 |
| 1518437474 | Lakewood Resource and Referral Center, Inc. | Clinic/Center | 485 Locust St, Lakewood, NJ 08701-5896 | 2018-12-04 |
| 1679931646 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 South Teller Street, Lakewood, CO 80235-2014 | 2016-02-05 |
| 1114213972 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 West 2nd Place, Lakewood, CO 80228-1506 | 2011-06-21 |
| 1558526418 | Metro Community Provider Network, Inc. | Clinic/Center | 8755 West 14th Avenue, Lakewood, CO 80215-4863 | 2008-07-21 |
| 1437314481 | Metro Community Provider Network, Inc. | Clinic/Center | 1255 South Wadsworth Blvd., Lakewood, CO 80232-5406 | 2008-07-18 |
| 1992965420 | Metro Community Provider Network, Inc. | Clinic/Center | 8500 West Colfax Avenue, Lakewood, CO 80215-4011 | 2008-06-09 |
| 1699778233 | The Lakes Community Health Center, Inc | Clinic/Center | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2005-05-27 |
| 1710980917 | Ocean Health Initiatives | Clinic/Center | 101 2nd St, Lakewood, NJ 08701-3324 | 2005-05-23 |
| 1447873773 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-21 |
| Find all providers in LAKEWOOD | ||||
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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.