HEALTHONE CLINIC SERVICES - OBSTETRICS AND GYNECOLOGY LLC

Provider Demographics

• NPI: 1831397215
• Name: HEALTHONE CLINIC SERVICES - OBSTETRICS AND GYNECOLOGY LLC
• Entity type: Organization
• Organization Name: HEALTHONE CLINIC SERVICES - OBSTETRICS AND GYNECOLOGY LLC
• Authorized Official - Title/Position: VP
• Authorized Official - First Name: JOHN
• Authorized Official - Last Name: REBOK
• Authorized Official - Phone: 615-372-5004
• Mailing Address - Street 1: 2000 HEALTH PARK DR
• Mailing Address - City: BRENTWOOD
• Mailing Address - State: TN
• Mailing Address - Zip Code: 37027-4525
• Mailing Address - Country: US
• Mailing Address - Phone: 615-372-5426
• Mailing Address - Fax: 866-831-4898
• Practice Address - Street 1: 1400 S POTOMAC ST STE 220
• Practice Address - City: AURORA
• Practice Address - State: CO
• Practice Address - Zip Code: 80012-4522
• Practice Address - Country: US
• Practice Address - Phone: 303-690-2198
• Practice Address - Fax: 303-369-1807
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-07-06
• Last Update Date: 2023-01-02

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207V00000X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology		Group - Multi-Specialty
No	261Q00000X	Ambulatory Health Care Facilities	Clinic/Center		Group - Multi-Specialty
No	367A00000X	Physician Assistants & Advanced Practice Nursing Providers	Advanced Practice Midwife		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
CO	28838041	Medicaid
CO	48336262	Medicaid
CO	59726059	Medicaid
CO	75887274	Medicaid
CO	87600579	Medicaid
CO	05006864	Medicaid
CO	32984049	Medicaid
CO	63223082	Medicaid
CO	07176848	Medicaid
CO	54025079	Medicaid
CO	76580237	Medicaid
CO	14776731	Medicaid
CO	48536873	Medicaid
CO	87588820	Medicaid
CO	22832564	Medicaid
CO	94022747	Medicaid
CO	99237041	Medicaid
CO	54532876	Medicaid
CO	05006864	Medicaid
CO	54532876	Medicaid