Healthcare Provider Details

I. General information

NPI: 1336014034
Provider Name (Legal Business Name): ROCKY MOUNTAIN GASTROENTEROLOGY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 UNION BLVD STE 200
LAKEWOOD CO
80228-1500
US

IV. Provider business mailing address

3333 S WADSWORTH BLVD UNIT D100
LAKEWOOD CO
80227-5117
US

V. Phone/Fax

Practice location:
  • Phone: 303-205-1090
  • Fax:
Mailing address:
  • Phone: 303-205-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER WHITE
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 303-205-1090