METRO COMMUNITY PROVIDER NETWORK, INC. (NPI# 1184961492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184961492 |
| Entity Type | Organization |
| Organization Name | METRO COMMUNITY PROVIDER NETWORK, INC. |
| Other Organization Name | JEFFCO FAMILY HEALTH SERVICES CENTER |
| Practice Address |
7495 West 29th Avenue Wheat Ridge CO 80033-8002 |
| Mailing Address |
2255 S Oneida St Denver CO 80224-2522 |
| Practice Telephone | 3032399964 |
| Practice Fax Number | 3032374343 |
| Mailing Telephone | 3037611977 |
| Mailing Fax Number | 3037612787 |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2020-03-10 |
| 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 |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
CO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 69585547 | 05 |
| Other Name | Type Code |
|---|---|
| Jeffco Family Health Services Center | Other Name - Individual/Organization |
| STRIDE CHC - Wheat Ridge | Doing Business As Name - Organization |
| STRIDE CHC-Jeffco Family Health Services Center | 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 |
| 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 |
| 1558657312 | Metro Community Provider Network, Inc. | Clinic/Center | 791 Chambers Rd Ste 220, Aurora, CO 80011-7112 | 2011-06-21 |
| Street Address |
7495 WEST 29TH AVENUE |
| City | WHEAT RIDGE |
| State | CO |
| Zip Code | 80033-8002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154893915 | Bronwyn Hockersmith | Counselor | 3954 Yosemite St, Wheat Ridge, CO 80033 | 2018-12-18 |
| 1902392004 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 4891 Independence St Ste 285, Wheat Ridge, CO 80033 | 2018-07-02 |
| 1528586120 | Front Range Family Resource Center | Marriage & Family Therapist | 5181 Ward St Ste 201, Wheat Ridge, CO 80033 | 2017-09-03 |
| 1962920918 | Dianna Lee Cordero | Counselor | 4931 Garrison St., Apt 104, Wheat Ridge, CO 80033 | 2017-08-30 |
| 1396261525 | Lauren Faye Petasne | Nurse Practitioner | 7100 W 44th Ave Ste 101a, Wheat Ridge, CO 80033 | 2017-08-18 |
| 1558802421 | Elizabeth Ann Huddleston | Nurse Practitioner | 3400 N Lutheran Pkwy, Wheat Ridge, CO 80033 | 2017-03-13 |
| 1053777045 | Richard Kerry Brandow | Counselor | 16625 W 50th Ave., Golden, CO 80033 | 2016-01-07 |
| 1831562131 | Eternal Life Care Centers, LLC | Assisted Living Facility | 4370 Ingalls Street, Wheat Ridge, CO 80033 | 2015-11-09 |
| 1740663483 | Real Care, Inc. | Private Vehicle | 10200 West 44th Ave, Suite 200, Wheat Ridge, CO 80033 | 2015-06-30 |
| 1508254848 | Pamela June Weitzel | Midwife | 3555 Lutheran Parkway Suite 210, Wheat Ridge, CO 80033 | 2015-01-08 |
| Find all providers in zip 80033 | ||||
| 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 |
|---|---|---|---|---|
| 1295356798 | Metro Community Provider Network, Inc. | Clinic/Center | 7495 W 29th Ave, Wheat Ridge, CO 80033-8002 | 2020-05-06 |
| 1083250229 | Metro Community Provider Network, Inc. | Clinic/Center | 7495 W 29th Ave, Wheat Ridge, CO 80033-8002 | 2019-11-22 |
| 1699311951 | Metro Community Provider Network, Inc. | Clinic/Center | 4851 Independence St, Wheat Ridge, CO 80033-6715 | 2019-11-21 |
| 1043856305 | Metro Community Provider Network, Inc. | Clinic/Center | 4851 Independence St, Wheat Ridge, CO 80033-6715 | 2019-11-21 |
| 1316233174 | Metro Community Provider Network, Inc. | Clinic/Center | 4851 Independence Street, Wheat Ridge, CO 80033-6715 | 2011-06-21 |
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|---|---|---|---|---|
| 1972118073 | Sunrise Community Health | Clinic/Center | 2880 Monroe Ave, Loveland, CO 80538-3274 | 2020-09-15 |
| 1538772892 | Valley-wide Health Systems, Inc. | Clinic/Center | 204 Carson Ave, Alamosa, CO 81101-2342 | 2020-08-26 |
| 1225640931 | Valley-wide Health Systems, Inc. | Clinic/Center | 1215 Main St Ste B, Canon City, CO 81212-3505 | 2020-08-24 |
| 1568073229 | Mountain Family Health Centers | Clinic/Center | 2270 Highway 133, Carbondale, CO 81623-9271 | 2020-08-14 |
| 1912515735 | Peak Vista Community Health Centers | Clinic/Center | 423 E Cucharras St Ste 2, Colorado Springs, CO 80903-3609 | 2020-07-17 |
| 1861014805 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-13 |
| 1548897648 | Plan De Salud Del Valle, Inc | Clinic/Center | 709 E Riverview Ave # 201, Fort Morgan, CO 80701-3263 | 2020-03-26 |
| 1093345886 | Marillac Clinic, Inc. | Clinic/Center | 550 Warrior Way, Grand Junction, CO 81504-6401 | 2020-01-21 |
| 1134766553 | Plan De Salud Del Valle, Inc | Clinic/Center | 562 Sable Blvd Ste 100, Aurora, CO 80011-0809 | 2019-12-04 |
| 1033755392 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 W 2nd Pl # 200, Lakewood, CO 80228-1506 | 2019-11-21 |
| Find all providers with the same taxonomy | ||||
| City | WHEAT RIDGE |
| Zip Code | 80033 |
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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.