KEYSTONE PRIMARY CARE


Address: 11111 E Mississippi Ave Ste 112, Aurora, CO 80012-3106
Phone: 3037555542

KEYSTONE PRIMARY CARE (NPI# 1386261493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386261493
Entity Type Organization
Organization Name KEYSTONE PRIMARY CARE
Practice Address 11111 E Mississippi Ave Ste 112
Aurora
CO 80012-3106
Practice Telephone 3037555542
Practice Fax Number 7207492121
Mailing Telephone 3037555542
Mailing Fax Number 7207492121
Enumeration Date 2020-07-06
Last Update Date 2020-07-06
Authorized Official Name MS. FATIMAH AISHA JOHNSON (NP)
Authorized Official Telephone 3037555542
Authorized Official Credential AG-NP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CO DEA LIC MJ4818879 01
CO NPI 1871081737 01
MEDICARE 653232 01
CO NP LIC 0993831 01

Other Provider/Organization Names

Other Name Type Code
Keystone Primary Care Doing Business As Name - Organization

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Keystone Primary Care LLC 4786 S Picadilly Court, Aurora, CO 80015

Office Location

Street Address 11111 E MISSISSIPPI AVE STE 112
City AURORA
State CO
Zip Code 80012-3106

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1548874761 Scl Health Medical Group - Denver, LLC Clinic/Center 23770 E Smoky Hill Rd Ste 240, Aurora, CO 80016-3089 2020-09-04
1275072472 Blue Nile Primary Care, LLC Clinic/Center 11275 E Mississippi Ave Ste 2w2, Aurora, CO 80012-3263 2017-02-21
1740685023 Robert R Greenheck, M.d. Clinic/Center 18962 E Kansas Dr, Aurora, CO 80017-4513 2014-10-28
1487925665 Ardas LLC Clinic/Center 10180 E Colfax Ave Ste 150, Aurora, CO 80010 2012-01-20
1740580562 Romanat Clinic, Inc Clinic/Center 13901 E. Exposition Ave, #230, Aurora, CO 80012-2535 2010-10-26
1124336524 Eyes of Chicago, Ltd Clinic/Center 3015 E New York St Ste A4, Aurora, IL 60504-5165 2010-09-20
1447445895 Community Health Services, Sc Clinic/Center 808 N Route 59, Aurora, IL 60504-4912 2007-09-10
1790390755 Tlc Medical, LLC Clinic/Center 729 N. Claymill Cutoff Rd, Aurora, UT 84620-8462 2020-09-15
1639784010 Scl Health Medical Group - Denver, LLC Clinic/Center 23770 E Smoky Hill Rd, Aurora, CO 80016-3089 2020-09-11
1447865829 Scl Health Medical Group - Denver, LLC Clinic/Center 23770 E Smoky Hill Rd Ste 240, Aurora, CO 80016-3089 2020-09-11
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Competitor

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City AURORA
Zip Code 80012

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Dataset Information

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.

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