Healthcare Provider Details

I. General information

NPI: 1760312797
Provider Name (Legal Business Name): MEDX COMMUNITY CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S ONEIDA ST STE 248
DENVER CO
80224-2551
US

IV. Provider business mailing address

PO BOX 400113
LAS VEGAS NV
89140-0113
US

V. Phone/Fax

Practice location:
  • Phone: 720-864-9434
  • Fax:
Mailing address:
  • Phone: 939-399-2059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRETT HEAP
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 949-417-6888