Healthcare Provider Details

I. General information

NPI: 1013849199
Provider Name (Legal Business Name): NEUROLOGY OF THE ROCKIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4450 UNION ST STE 201
JOHNSTOWN CO
80534-2864
US

IV. Provider business mailing address

PO BOX 630920
LITTLETON CO
80163-0920
US

V. Phone/Fax

Practice location:
  • Phone: 970-400-0318
  • Fax:
Mailing address:
  • Phone: 303-840-5051
  • Fax: 303-840-5058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAVI C SHAH
Title or Position: PRESIDENT
Credential:
Phone: 303-840-5051