Healthcare Provider Details

I. General information

NPI: 1770660409
Provider Name (Legal Business Name): COLORADO PULMONARY INTENSIVISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 W DRY CREEK CIR
LITTLETON CO
80120-4427
US

IV. Provider business mailing address

15 W DRY CREEK CIR
LITTLETON CO
80120-4427
US

V. Phone/Fax

Practice location:
  • Phone: 303-952-1100
  • Fax: 303-952-8185
Mailing address:
  • Phone: 303-952-1100
  • Fax: 303-952-8185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KELLY GREENE
Title or Position: OWNER
Credential: MD
Phone: 303-919-3869