Provider Demographics
NPI:1922548973
Name:ONPOINT MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:ONPOINT MEDICAL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHACON-JARAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-439-2456
Mailing Address - Street 1:8055 E TUFTS AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2854
Mailing Address - Country:US
Mailing Address - Phone:720-439-2456
Mailing Address - Fax:720-572-5112
Practice Address - Street 1:7780 S BROADWAY
Practice Address - Street 2:SUITE 280
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2633
Practice Address - Country:US
Practice Address - Phone:303-738-1000
Practice Address - Fax:303-738-1310
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONPOINT MEDICAL GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000153969Medicaid
CO9000153964Medicaid