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NPI Code Detail

MEDICARE: JASTERHEALTH PREVENTIVE & WELLNESS MEDICINE, LLC

MEDICARE: JASTERHEALTH PREVENTIVE & WELLNESS MEDICINE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician41530CO

General Provider Information

NPI Number : 1528303500
Entity Type Code : Organization
Provider Name (Legal Business Name) : JASTERHEALTH PREVENTIVE & WELLNESS MEDICINE, LLC
Provider Business Mailing Address
First Line : 1777 S HARRISON ST STE 1200
Second Line :
City : DENVER
State : CO
Zip : 80210-3955
Country : US
Telephone Number : 800-651-7126
Fax Number :
Provider Business Practice Location Address
First Line : 1777 S HARRISON ST STE 1200
Second Line :
City : DENVER
State : CO
Zip : 80210-3955
Country : US
Telephone Number : 800-651-7126
Fax Number : 844-341-5519
Authorized Official
Title or Position : PRESIDENT
Name : BRENT JASTER
Credential : MD
Telephone Number : 800-651-7126
Provider Enumeration Date : 12/03/2012
Last Update Date : 04/15/2025

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