MILE HIGH PSYCHIATRY LLC (NPI# 1386290799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386290799 |
| Entity Type | Organization |
| Organization Name | MILE HIGH PSYCHIATRY LLC |
| Other Organization Name | MILE HIGH PSYCHIATRY |
| Practice Address |
7100 W 44th Ave Ste 101a Wheat Ridge CO 80033-4701 |
| Mailing Address |
15355 E Colfax Ave Unit 111717 Aurora CO 80042-1975 |
| Practice Telephone | 7205074779 |
| Practice Fax Number | 7203675067 |
| Mailing Telephone | 7205074779 |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2020-04-09 |
| Authorized Official Name | MICHAEL KEITH CHISM II (CEO/PSYCHIATRIC DIRECTOR) |
| Authorized Official Telephone | 7205074779 |
| Authorized Official Credential | PMHNP -BC |
| Is Organization Subpart | Y |
| Parent Organization Name | MILE HIGH PSYCHIATRY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 9000151751 | 05 |
| Other Name | Type Code |
|---|---|
| Mile High Psychiatry | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538706122 | Mile High Psychiatry LLC | Nurse Practitioner | 8089 S Lincoln St Ste 207, Littleton, CO 80122-2720 | 2019-12-03 |
| 1366099020 | Mile High Psychiatry LLC | Nurse Practitioner | 3330 N 2nd St Ste 500, Phoenix, AZ 85012-2367 | 2019-08-19 |
| 1568018695 | Mile High Psychiatry LLC | Nurse Practitioner | 4545 Post Oak Place Dr Ste 110, Houston, TX 77027-3105 | 2019-08-14 |
| 1760928766 | Mile High Psychiatry LLC | Nurse Practitioner | 14221 E 4th Ave Ste 2-126, Aurora, CO 80011-8735 | 2017-01-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Mile High Psychiatry LLC | 14221 East 4th Avenue, Suite 2-126, Aurora, CO 80011 |
| Street Address |
7100 W 44TH AVE STE 101A |
| City | WHEAT RIDGE |
| State | CO |
| Zip Code | 80033-4701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396261525 | Lauren Faye Petasne | Nurse Practitioner | 7100 W 44th Ave Ste 101a, Wheat Ridge, CO 80033 | 2017-08-18 |
| 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 |
| 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 |
| 1346656071 | Jose Ramon | Social Worker | 4860 Robb St Ste 201, Wheat Ridge, CO 80033 | 2014-07-02 |
| Find all providers in zip 80033 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386119568 | James E Camp | Nurse Practitioner | 4851 Independence St, Wheat Ridge, CO 80033-6715 | 2018-10-03 |
| 1952803082 | Britt Ritchie | Nurse Practitioner | 4851 Independence St, Wheat Ridge, CO 80033-6715 | 2018-03-05 |
| 1508310558 | Marlene Alice Pino | Nurse Practitioner | 4851 Independence St, Wheat Ridge, CO 80033-6715 | 2016-08-08 |
| 1184751141 | Carol A Annibella | Nurse Practitioner | 4851 Independence St Ste 270, Wheat Ridge, CO 80033-6712 | 2007-02-27 |
| 1972608883 | Carol Robertson Olson | Nurse Practitioner | 3400 Lutheran Pkwy, Wheat Ridge, CO 80033-6035 | 2006-09-14 |
| 1700998036 | Richard Elliott Craven | Nurse Practitioner | 4851 Independence St, 100, Wheat Ridge, CO 80033-6715 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104430719 | Mam Psychiatry, LLC | Nurse Practitioner | 770 W Hampden Ave Ste 325, Englewood, CO 80110-2133 | 2020-09-01 |
| 1528678372 | Chelsey Mcfaddin | Nurse Practitioner | 14221 E 4th Ave # 2-126, Aurora, CO 80011-8735 | 2020-08-06 |
| 1912517293 | Viewpoints Psychotherapy Services, LLC | Nurse Practitioner | 1017 E Us Highway 24 # 2138, Woodland Park, CO 80863-2120 | 2020-08-03 |
| 1316555386 | Comfort of Your Home Psychiatry | Nurse Practitioner | 175 Hurd Lane, Unit 3212, Avon, CO 81620 | 2020-07-16 |
| 1265040117 | Integrative Psychiatric Services | Nurse Practitioner | 204 Walnut St Ste A, Fort Collins, CO 80524-4439 | 2020-07-16 |
| 1417574815 | Acorn Behavioral Health Services LLC | Nurse Practitioner | 1425 W 29th St, Loveland, CO 80538-2403 | 2020-07-01 |
| 1760009617 | Tiffany Taylor | Nurse Practitioner | 4729 Opus Dr, Colorado Springs, CO 80906-8694 | 2020-06-26 |
| 1578189791 | Bailey Et Al Pllc | Nurse Practitioner | 3005 Anchor Way Apt 1, Fort Collins, CO 80525-4716 | 2020-06-23 |
| 1407471774 | Meditelecare of Colorado LLC | Nurse Practitioner | 1900 W Littleton Blvd, Littleton, CO 80120-2023 | 2020-06-12 |
| 1699399030 | Denmind Psychiatric Solutions Pllc | Nurse Practitioner | 600 17th St Ste 2800, Denver, CO 80202-5428 | 2020-06-01 |
| 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.