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NPI Code Detail

MEDICARE: CHELSEA CARRUTHERS PHYSICIAN ASSISTANT

MEDICARE: CHELSEA CARRUTHERS PHYSICIAN ASSISTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant9111568FL
2363AS0400XSurgical Physician AssistantPA.0006116CO
3363A00000XPhysician AssistantPA.0006116CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588148985
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA CARRUTHERS PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : PO BOX 5693
Second Line :
City : DENVER
State : CO
Zip : 80217-5693
Country : US
Telephone Number : 303-306-7783
Fax Number : 303-306-7753
Provider Business Practice Location Address
First Line : 11750 W 2ND PL STE 255
Second Line :
City : LAKEWOOD
State : CO
Zip : 80228-1726
Country : US
Telephone Number : 720-638-7500
Fax Number : 720-321-8041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2018
Last Update Date : 02/09/2026

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