Healthcare Provider Details

I. General information

NPI: 1417844978
Provider Name (Legal Business Name): VALLEY HOPE MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7108 S ALTON WAY STE A
CENTENNIAL CO
80112-2108
US

IV. Provider business mailing address

PO BOX 800081
KANSAS CITY MO
64180-0081
US

V. Phone/Fax

Practice location:
  • Phone: 303-694-3829
  • Fax: 303-694-3846
Mailing address:
  • Phone: 785-877-5111
  • Fax: 785-877-2322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KATHY ERBERT
Title or Position: DIR. OF CONTRACT ADMIN
Credential:
Phone: 785-877-5111