Healthcare Provider Details
I. General information
NPI: 1972733004
Provider Name (Legal Business Name): HEALTHONE HIGH STREET PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2009
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1721 E 19TH AVE SUITE 500
DENVER CO
80218-1251
US
IV. Provider business mailing address
2000 HEALTH PARK DR
BRENTWOOD TN
37027-4692
US
V. Phone/Fax
- Phone: 303-869-2160
- Fax: 303-869-2544
- Phone: 615-373-7406
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 26186 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | 26186 |
| License Number State | CO |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 26186 |
| License Number State | CO |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | 26186 |
| License Number State | CO |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0000X |
| Taxonomy | Adolescent Medicine (Internal Medicine) Physician |
| License Number | 26186 |
| License Number State | CO |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 26186 |
| License Number State | CO |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 26186 |
| License Number State | CO |
VIII. Authorized Official
Name:
THOMAS
FENDER
Title or Position: VICE PRESIDENT
Credential: M.D.
Phone: 303-584-8111