=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033135520
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CRITICAL CARE & PULMONARY CONSULTANTS, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2006
-----------------------------------------------------
Last Update Date | 06/14/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7100 E BELLEVIEW AVE STE G10
-----------------------------------------------------
City | GREENWOOD VILLAGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111-1634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-745-0000
-----------------------------------------------------
Fax | 303-773-3675
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7100 E BELLEVIEW AVE STE G10
-----------------------------------------------------
City | GREENWOOD VILLAGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111-1634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-745-0000
-----------------------------------------------------
Fax | 303-773-3675
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DELEGATE
-----------------------------------------------------
Name | CATHLEEN FERGUSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 303-745-0000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------