Healthcare Provider Details

I. General information

NPI: 1902549025
Provider Name (Legal Business Name): NATHAN REID BROTT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2022
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 AURORA CT FL 6
AURORA CO
80045-2612
US

IV. Provider business mailing address

12801 E 17TH AVE # 7130
AURORA CO
80045-2530
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-3921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0077592
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number74214
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: