Healthcare Provider Details

I. General information

NPI: 1457493660
Provider Name (Legal Business Name): BOULDER VALLEY NEUROLOGY P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 S TAYLOR AVE UNIT 160
LOUISVILLE CO
80027-3150
US

IV. Provider business mailing address

183 S TAYLOR AVE UNIT 160
LOUISVILLE CO
80027-3150
US

V. Phone/Fax

Practice location:
  • Phone: 303-926-1015
  • Fax: 303-926-1032
Mailing address:
  • Phone: 303-926-1015
  • Fax: 303-926-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number42528
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number42528
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number42528
License Number StateCO

VIII. Authorized Official

Name: DR. THOMAS M RAMPY
Title or Position: OWNER
Credential: M.D.
Phone: 303-926-1015