Provider Demographics
NPI:1134429699
Name:ONPOINT MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:ONPOINT MEDICAL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHITEHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-357-2559
Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-357-2559
Mailing Address - Fax:
Practice Address - Street 1:19641 E PARKER SQUARE DR
Practice Address - Street 2:STE E
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7399
Practice Address - Country:US
Practice Address - Phone:303-805-2222
Practice Address - Fax:303-805-2255
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONPOINT MEDICAL GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-29
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000153819Medicaid
CO9000152831Medicaid