# INTERMOUNTAIN MEDICAL GROUP DENVER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTERMOUNTAIN FRONT RANGE, INC.
- **Other names:** Denver West Clinic - Prmary Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114531522
- **Legal business name:** INTERMOUNTAIN FRONT RANGE, INC.
- **Authorized official:** JON MCDANIEL (VP FINANCE MEDICAL GROUP)
- **Authorized official phone:** (303) 272-0231

## Contact information

- **Practice address:** 1726 COLE BLVD STE 350, LAKEWOOD, CO 80401-3213
- **Practice address phone:** (303) 403-7381
- **Practice address fax:** (303) 403-7392
- **Mailing address:** 500 ELDORADO BLVD STE 6300, BROOMFIELD, CO 80021-3422
- **Mailing address phone:** (303) 272-0566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/02/2020
- **Last updated:** 12/03/2024