Provider Demographics
NPI:1679813851
Name:ONPOINT MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:ONPOINT MEDICAL GROUP, LLC
Other - Org Name:LONE TREE PEDIATRICS - MAIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, INTEGRATION
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LENNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-359-2557
Mailing Address - Street 1:1805 SHEA CENTER DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2277
Mailing Address - Country:US
Mailing Address - Phone:303-357-2559
Mailing Address - Fax:
Practice Address - Street 1:10099 RIDGEGATE PKWY STE 290
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5534
Practice Address - Country:US
Practice Address - Phone:303-803-1005
Practice Address - Fax:303-798-3248
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONPOINT MEDICAL GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-25
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000153112Medicaid
CO9000153818Medicaid