Provider Demographics
NPI:1740205152
Name:PRICE, JENNIFER REBECCA (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:REBECCA
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14701 E EXPOSITION AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2623
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32593207V00000X
CO48089207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO020421OtherKAISER COMMERCIAL NUMBER
1245344316OtherCLINIC NPI
1962507376OtherCLINIC NPI
CO20022816Medicaid
1063433720OtherCLINIC NPI
1043324932OtherCLINIC NPI
AZ852609Medicaid
AZ852609Medicaid
AZZ112224Medicare PIN
1043324932OtherCLINIC NPI
AZZ21116Medicare PIN
COCO306540Medicare PIN
031805Medicare Oscar/Certification
031822Medicare Oscar/Certification
1063433720OtherCLINIC NPI
I03847Medicare UPIN
AZZ21115Medicare PIN
AZZ21113Medicare PIN
CO020421OtherKAISER COMMERCIAL NUMBER
031823Medicare Oscar/Certification
031824Medicare Oscar/Certification
AZZ21114Medicare PIN
AZZ112222Medicare PIN