Healthcare Provider Details

I. General information

NPI: 1194312959
Provider Name (Legal Business Name): CAREPOINT OUTPATIENT BLUE SKY NEUROLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2020
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E 9TH AVE STE 710
DENVER CO
80220-3926
US

IV. Provider business mailing address

PO BOX 17528
DENVER CO
80217-0528
US

V. Phone/Fax

Practice location:
  • Phone: 303-781-4485
  • Fax: 720-274-0064
Mailing address:
  • Phone: 720-781-4485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH SMITH
Title or Position: VP/ GENERAL COUNSEL
Credential:
Phone: 303-436-2720