MEDICARE: MR. JOHNATHAN D COSEY KIDNEY DISEASE ANALY

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
1	146N00000X	Basic Emergency Medical Technician		CO
2	1710I1003X	Independent Duty Medical Technicians		CO

General Provider Information

NPI Number	:	1629933510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHNATHAN D COSEY KIDNEY DISEASE ANALY

Provider Business Mailing Address
First Line	:	4295 S NAPLES WAY
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80013-2922
Country	:	US
Telephone Number	:	720-205-8923
Fax Number	:

Provider Business Practice Location Address
First Line	:	4295 S NAPLES WAY
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80013-2922
Country	:	US
Telephone Number	:	720-205-8923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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Directions to “ MR. JOHNATHAN D COSEY KIDNEY DISEASE ANALY” Practice Location

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