Healthcare Provider Details

I. General information

NPI: 1760278022
Provider Name (Legal Business Name): MEDICAL NUTRITION THERAPY ASSOCIATES OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10100 TWENTY MILE RD
PARKER CO
80134-6453
US

IV. Provider business mailing address

22053 DAY STAR DR
PARKER CO
80138-8356
US

V. Phone/Fax

Practice location:
  • Phone: 303-276-1900
  • Fax: 888-892-4064
Mailing address:
  • Phone: 303-204-6444
  • Fax: 888-892-4064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: JOANNA CUMMINGS
Title or Position: OWNER, CLINICIAN
Credential: MS, RD-AP
Phone: 303-276-1900