Provider Demographics
NPI:1114396686
Name:ELEVATION FOOT AND ANKLE, PLLC
Entity Type:Organization
Organization Name:ELEVATION FOOT AND ANKLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:LEANN
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-388-0976
Mailing Address - Street 1:3445 E 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5025
Mailing Address - Country:US
Mailing Address - Phone:303-388-0976
Mailing Address - Fax:
Practice Address - Street 1:3445 E 28TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5025
Practice Address - Country:US
Practice Address - Phone:303-388-0976
Practice Address - Fax:303-388-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000743213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85688347Medicaid
378992YNSRMedicare PIN