Provider Demographics
NPI:1487291233
Name:NEXT DOOR HEALTH CARE
Entity type:Organization
Organization Name:NEXT DOOR HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:720-285-8159
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:BYERS
Mailing Address - State:CO
Mailing Address - Zip Code:80103-0279
Mailing Address - Country:US
Mailing Address - Phone:720-887-7792
Mailing Address - Fax:720-399-0018
Practice Address - Street 1:40505 TOPAZ DR
Practice Address - Street 2:
Practice Address - City:DEER TRAIL
Practice Address - State:CO
Practice Address - Zip Code:80105-7929
Practice Address - Country:US
Practice Address - Phone:720-285-8159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO75189879Medicaid