Healthcare Provider Details

I. General information

NPI: 1285823963
Provider Name (Legal Business Name): GERAGHTY FAMILY MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6746 S REVERE PKWY STE 180
CENTENNIAL CO
80112-6763
US

IV. Provider business mailing address

6746 S REVERE PKWY STE 180
CENTENNIAL CO
80112-6763
US

V. Phone/Fax

Practice location:
  • Phone: 303-632-3640
  • Fax: 303-632-3642
Mailing address:
  • Phone: 303-632-3640
  • Fax: 303-632-3642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33711
License Number StateCO

VIII. Authorized Official

Name: DR. JOHN STEVEN GERAGHTY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 303-632-3640