Provider Demographics
NPI:1295735694
Name:RUMBYRT, JEFFREY SCOT (M D)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:SCOT
Last Name:RUMBYRT
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1746 COLE BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3208
Mailing Address - Country:US
Mailing Address - Phone:303-234-1067
Mailing Address - Fax:
Practice Address - Street 1:1746 COLE BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3208
Practice Address - Country:US
Practice Address - Phone:303-234-1067
Practice Address - Fax:303-232-2967
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0427760207K00000X
CO31974207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01319748Medicaid
KS130443OtherKANSAS MEDICARE
KS100355080AOtherKANSAS MEDICAID
F72324Medicare UPIN
KS100355080AOtherKANSAS MEDICAID