Provider Demographics
NPI:1497901409
Name:ROLINGHER, FREDERICK SHAWN (PA-C)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:SHAWN
Last Name:ROLINGHER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-837-0072
Mailing Address - Fax:303-837-0075
Practice Address - Street 1:88 INVERNESS CIR E UNIT J106
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5527
Practice Address - Country:US
Practice Address - Phone:303-799-1600
Practice Address - Fax:303-452-4625
Is Sole Proprietor?:No
Enumeration Date:2008-08-10
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.00026362084P0800X, 2084P0804X
COPA2636363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1497901409Medicaid
CO63050234Medicaid
COCOA102915Medicare PIN