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General NPI Number Information
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NPI Number | 1255284600
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Entity Type | Organization
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Legal Business Name | MEDX COMMUNITY CLINIC
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 2121 S ONEIDA ST STE 248
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City | DENVER
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State | CO
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Zip | 80224-2551
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Country | US
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Telephone | 720-864-9434
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Fax | 720-899-3728
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Provider Business Mailing Address
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Address Line | PO BOX 400113
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City | LAS VEGAS
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State | NV
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Zip | 89140-0113
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BRETT HEAP
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Credential |
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Telephone | 949-417-6888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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