NPI 1366447484 · Family Practice · Anthem
Carrier listings present but Colorado DORA license appears expired or revoked.
NPPES
HIGHLANDS RANCH, 80130
Freshness: Unknown
Network Status
Listed with 4 carriers
DORA License
Expired
Medicare
492 services
176 beneficiaries
$23,129.93 total payment
Specialty: Family Practice
Care Compare
Address mismatch with NPPES
PECOS Enrollment
Medicare enrolled
Order/Referring eligible: Yes
Active NPI with specialty classification
DORA license expired or revoked
Active Medicare billing confirmed
Single address source (NPPES)
Limited carrier network presence
3 networks across 2 carriers
Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.