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MAGNOLIA MEDICAL GROUP
NPI 1003672619
Internal Medicine - Addiction Medicine in Denver, CO

Active since February 22, 2024CLIA Certified · 3 labs
1490 N LAFAYETTE ST STE 104, DENVER, CO 80218(303) 209-5115 Get Directions Write a Review

NPPES record last updated: February 17, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Magnolia Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAGNOLIA MEDICAL GROUP (NPI 1003672619) is a healthcare organization registered as an addiction medicine in Denver, Colorado and active in the NPI registry since February 2024. The organization holds 3 active CLIA laboratory certificates and lists Pradeep Rai, Director, as its authorized official.

NPPES Registry Identity

NPI1003672619
Entity TypeOrganization
Primary Taxonomy207RA0401X
Legal Business NameMAGNOLIA MEDICAL GROUP
Location Address1490 N LAFAYETTE ST STE 104Denver, CO 80218-2391
Mailing AddressPo Box 29605, Dept # 800927Phoenix, AZ 85038-9605 · (303) 209-5115 · Fax (720) 638-5562
Phone(303) 209-5115
Organization SubpartNo
Authorized OfficialPradeep RaiDirector · (303) 209-5115
Enumeration DateFebruary 22, 2024
Last NPPES UpdateFebruary 17, 2026
NPPES CertifiedFebruary 17, 2026
✔ NPI 1003672619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0401X
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
1490 N LAFAYETTE ST STE 104, Denver, CO 80218
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 06D2158266

Magnolia Medical Group · Denver, CO
Active · expires Nov 25, 2026
CLIA Number06D2158266
Laboratory TypePhysician Office
Certificate Effective DateNovember 26, 2024
Certificate Expiration DateNovember 25, 2026
Laboratory DirectorDr. Pradeep R. Rai
Laboratory Phone(303) 955-5131
Laboratory LocationMagnolia Medical Group1490 N Lafayette St, Suite 104, Denver, CO 80218
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 06D2121590

Magnolia Medical Group · Denver, CO
Active · expires Jul 27, 2027
CLIA Number06D2121590
Laboratory TypePhysician Office
Certificate Effective DateJuly 28, 2025
Certificate Expiration DateJuly 27, 2027
Laboratory DirectorDr. Kathryn Lloyd
Laboratory Phone(303) 209-5115
Laboratory LocationMagnolia Medical Group10515 East 40th Ave Suite 115, Denver, CO 80239
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 06D2157528

Magnolia Medical Group · Denver, CO
Active · expires Nov 6, 2026
CLIA Number06D2157528
Laboratory TypePhysician Office
Certificate Effective DateNovember 7, 2024
Certificate Expiration DateNovember 6, 2026
Laboratory DirectorDr. Pradeep R. Rai
Laboratory Phone(303) 209-5115
Laboratory LocationMagnolia Medical Group2925 E Colfax Ave, Denver, CO 80206
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Magnolia Medical Group's NPI number?

The NPI number for Magnolia Medical Group is 1003672619. It was assigned to this organization in the NPPES registry on February 22, 2024.

Where is Magnolia Medical Group located?

Magnolia Medical Group is located at 1490 N Lafayette St Ste 104, Denver, CO 80218. The listed phone number is (303) 209-5115.

What is Magnolia Medical Group's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

Does Magnolia Medical Group hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Magnolia Medical Group was last updated on February 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.