Provider Demographics
NPI:1770507360
Name:NORTHERN MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:NORTHERN MEDICAL ASSOCIATES
Other - Org Name:BROOMFIELD FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-466-1866
Mailing Address - Street 1:1420 W MIDWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2090
Mailing Address - Country:US
Mailing Address - Phone:303-466-1866
Mailing Address - Fax:303-466-4081
Practice Address - Street 1:1420 W MIDWAY BLVD
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2090
Practice Address - Country:US
Practice Address - Phone:303-466-1866
Practice Address - Fax:303-466-4081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COBRL7008OtherBCBS
CO5135268Medicare ID - Type Unspecified