Provider Demographics
| NPI: | 1225571425 |
|---|---|
| Name: | ORTHOPEDIC CENTERS OF COLORADO, LLC |
| Entity Type: | Organization |
| Organization Name: | ORTHOPEDIC CENTERS OF COLORADO, LLC |
| Other - Org Name: | CORNERSTONE ORTHOPEDICS SURGERY AND SPORTS MEDICINE, P.C. |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DAVIS |
| Authorized Official - Middle Name: | K |
| Authorized Official - Last Name: | HURLEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 303-344-9090 |
| Mailing Address - Street 1: | 3455 LUTHERAN PKWY STE 105 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WHEAT RIDGE |
| Mailing Address - State: | CO |
| Mailing Address - Zip Code: | 80033-6028 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 303-665-2603 |
| Mailing Address - Fax: | 303-665-2605 |
| Practice Address - Street 1: | 500 W 144TH AVE |
| Practice Address - Street 2: | SUITE 230 |
| Practice Address - City: | WESTMINSTER |
| Practice Address - State: | CO |
| Practice Address - Zip Code: | 80023-9324 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 303-665-2603 |
| Practice Address - Fax: | 303-665-2605 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2016-11-21 |
| Last Update Date: | 2020-10-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 207XP3100X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Pediatric Orthopaedic Surgery | Group - Multi-Specialty |
| No | 207XS0106X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | Group - Multi-Specialty |
| No | 207XS0114X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery | Group - Multi-Specialty |
| No | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | Group - Multi-Specialty |
| No | 207XX0004X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery | Group - Multi-Specialty |
| No | 207XX0005X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | Group - Multi-Specialty |
| No | 207XX0801X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma | Group - Multi-Specialty |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
