METRO COMMUNITY PROVIDER NETWORK, INC. (NPI# 1013203876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013203876 |
| Entity Type | Organization |
| Organization Name | METRO COMMUNITY PROVIDER NETWORK, INC. |
| Other Organization Name | COLFAX HEALTH CENTER AT JEFFERSON CENTER FOR MENTAL HEALTH |
| Practice Address |
9485 W Colfax Ave Lakewood CO 80215-3918 |
| Mailing Address |
3701 South Broadway Englewood CO 80113-3611 |
| Practice Telephone | 3032056883 |
| Practice Fax Number | 3032056884 |
| Mailing Telephone | 3037611977 |
| Mailing Fax Number | 3037612787 |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2017-10-19 |
| Authorized Official Name | MR. BEN R. WIEDERHOLT (PRESIDENT AND CEO) |
| Authorized Official Telephone | 3037611977 |
| Is Organization Subpart | Y |
| Parent Organization Name | METRO COMMUNITY PROVIDER NETWORK, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
CO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 12702340 | 05 | |
| CO | 60380578 | 05 |
| Other Name | Type Code |
|---|---|
| Colfax Health Center at Jefferson Center for Mental Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014805 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-13 |
| 1033755392 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 W 2nd Pl # 200, Lakewood, CO 80228-1506 | 2019-11-21 |
| 1952853772 | Metro Community Provider Network, Inc. | Clinic/Center | 6303 Wadsworth Bypas, Arvada, CO 80003 | 2016-10-27 |
| 1679931646 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 South Teller Street, Lakewood, CO 80235-2014 | 2016-02-05 |
| 1558727883 | Metro Community Provider Network, Inc. | Clinic/Center | 10680 Del Mar Parkway, Aurora, CO 80010-4011 | 2015-12-31 |
| 1649605536 | Metro Community Provider Network, Inc. | Clinic/Center | 1537 Alton Street, Aurora, CO 80010-1712 | 2013-09-10 |
| 1811333842 | Metro Community Provider Network, Inc. | Clinic/Center | 1666 Elmira Street, Aurora, CO 80110-2122 | 2013-05-16 |
| 1184961492 | Metro Community Provider Network, Inc. | Clinic/Center | 7495 West 29th Avenue, Wheat Ridge, CO 80033-8002 | 2013-01-07 |
| 1568707776 | Metro Community Provider Network, Inc. | Clinic/Center | 15501 East 13th Avenue, Aurora, CO 80011-7203 | 2012-11-29 |
| 1114213972 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 West 2nd Place, Lakewood, CO 80228-1506 | 2011-06-21 |
| Street Address |
9485 W COLFAX AVE |
| City | LAKEWOOD |
| State | CO |
| Zip Code | 80215-3918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861574642 | Jefferson Center for Mental Health | Pharmacy | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2006-10-20 |
| 1407367337 | Kristi Lynne Snyder | Peer Specialist | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2017-10-18 |
| 1144758525 | Kurtt Walton | Nurse Practitioner | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2017-05-30 |
| 1285162065 | Danielle Ann Spratt | Counselor | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2017-05-24 |
| 1194262691 | Taylor Oliivia Haag | Counselor | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2017-01-23 |
| 1346784345 | Sandra Paolini | Pharmacist | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2016-12-09 |
| 1285187153 | Erin Isabel Dooley | Counselor | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2016-07-27 |
| 1982055802 | Emily Marie Pearl Adams | Counselor | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2016-06-22 |
| 1821459702 | Dana Gallagher | Counselor | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2016-03-18 |
| 1558720896 | Virginia Low | Counselor | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2016-02-15 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1679199566 | Alta Vista Center for Autism | Speech-Language Pathologist | 2001 Hoyt Street, Lakewood, CO 80215 | 2020-06-17 |
| 1871154419 | Ahc of Lakewood, LLC | Skilled Nursing Facility | 1565 Pierson Street, Lakewood, CO 80215 | 2019-06-25 |
| 1235646209 | Ashley Wiersma | Social Worker | 9485 W. Colfax Ave, Lakewood, CO 80215 | 2017-12-29 |
| 1619480563 | Amy Christine Ladebue | Counselor | 2596 Moore St, Lakewood, CO 80215 | 2017-11-14 |
| 1407374408 | Carly Young | Physician Assistant | 11171 W 17th Ave, Apt 303, Lakewood, CO 80215 | 2017-08-30 |
| 1356876700 | Our Family Care Home Assisted Living LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1169 Johnson Street, Lakewood, CO 80215 | 2017-04-24 |
| 1194263251 | Daniela Rosenberg | Student in an Organized Health Care Education/Training Program | 9845 W. Colfax Avenue, Jefferson Center for Mental Health, Lakewood, CO 80215 | 2017-02-08 |
| 1033596747 | Autumn Grove | Physical Therapist | 11185 W. 6th Avenue, Lakewood, CO 80215 | 2015-05-01 |
| 1649690264 | Neil George Norton | Dentist | 9990 W. 26th Ave, Lakewood, CO 80215 | 2014-04-22 |
| 1366873820 | Whitney Anne Post | Counselor | 1439 Estes St., Lakewood, CO 80215 | 2013-12-10 |
| Find all providers in zip 80215 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014805 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-13 |
| 1033755392 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 W 2nd Pl # 200, Lakewood, CO 80228-1506 | 2019-11-21 |
| 1518437474 | Lakewood Resource and Referral Center, Inc. | Clinic/Center | 485 Locust St, Lakewood, NJ 08701-5896 | 2018-12-04 |
| 1679931646 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 South Teller Street, Lakewood, CO 80235-2014 | 2016-02-05 |
| 1114213972 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 West 2nd Place, Lakewood, CO 80228-1506 | 2011-06-21 |
| 1558526418 | Metro Community Provider Network, Inc. | Clinic/Center | 8755 West 14th Avenue, Lakewood, CO 80215-4863 | 2008-07-21 |
| 1437314481 | Metro Community Provider Network, Inc. | Clinic/Center | 1255 South Wadsworth Blvd., Lakewood, CO 80232-5406 | 2008-07-18 |
| 1992965420 | Metro Community Provider Network, Inc. | Clinic/Center | 8500 West Colfax Avenue, Lakewood, CO 80215-4011 | 2008-06-09 |
| 1699778233 | The Lakes Community Health Center, Inc | Clinic/Center | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2005-05-27 |
| 1710980917 | Ocean Health Initiatives | Clinic/Center | 101 2nd St, Lakewood, NJ 08701-3324 | 2005-05-23 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.