1. Home
  2. Directory
  3. Colorado
  4. Longmont
  5. Specialist
  6. NPI Profile

BOULDER PLASTIC SURGERY PROF LLC
NPI 1114513009
Specialist in Longmont, CO

Active since December 15, 2020
1750 E KEN PRATT BLVD, LONGMONT, CO 80504(720) 718-7000 Get Directions Write a Review

NPPES record last updated: December 15, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Boulder Plastic Surgery Prof Llc NPPES

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

BOULDER PLASTIC SURGERY PROF LLC (NPI 1114513009) is a healthcare organization registered as a specialist in Longmont, Colorado and active in the NPI registry since December 2020. The organization lists Pam Garcia, Office Contact, as its authorized official.

NPPES Registry Identity

NPI1114513009
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBOULDER PLASTIC SURGERY PROF LLC
Location Address1750 E KEN PRATT BLVDLongmont, CO 80504-5311
Mailing AddressPo Box 7643Loveland, CO 80537-0643 · (970) 663-2742
Phone(720) 718-7000
Organization SubpartNo
Authorized OfficialPam GarciaOffice Contact · (303) 443-2277
Enumeration DateDecember 15, 2020
NPPES CertifiedDecember 15, 2020
✔ NPI 1114513009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

1750 E KEN PRATT BLVD, Longmont, CO 80504
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER ANDREW KOERBER DO
Internal Medicine
1750 E KEN PRATT BLVD
LONGMONT, CO 80504
Weld County (720) 718-7000
MONIQUE ANNE RANSFORD PA-C
Physician Assistant (Surgical)
1750 E KEN PRATT BLVD
LONGMONT, CO 80504
Weld County (720) 718-8288
MAKAYLA LINN HESSELTINE NP-C
Nurse Practitioner (Family)
1750 E KEN PRATT BLVD
LONGMONT, CO 80504
Weld County (720) 718-7000
MRS. KATIE ANN MARTIN FNP-C
Nurse Practitioner (Family)
1750 E KEN PRATT BLVD
LONGMONT, CO 80504
Weld County (720) 718-3900
MS. LEEANN RENEE KELLER NP
Nurse Practitioner (Family)
1750 E KEN PRATT BLVD
LONGMONT, CO 80504
Weld County (720) 718-8288
DR. ANITA R. RITENOUR MD
Internal Medicine
1750 E KEN PRATT BLVD
LONGMONT, CO 80504
Weld County (720) 718-7000
DORA J PAOLILLO LCSW
Social Worker (Clinical)
1750 E KEN PRATT BLVD
LONGMONT, CO 80504
Weld County (720) 718-7000
JOSHUA ZIMMERMAN PHARMD
Pharmacist
1750 E KEN PRATT BLVD
LONGMONT, CO 80504
Weld County (720) 718-7000

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 Boulder Plastic Surgery Prof LLC's NPI number?

The NPI number for Boulder Plastic Surgery Prof LLC is 1114513009. It was assigned to this organization in the NPPES registry on December 15, 2020.

Where is Boulder Plastic Surgery Prof LLC located?

Boulder Plastic Surgery Prof LLC is located at 1750 E Ken Pratt Blvd, Longmont, CO 80504. The listed phone number is (720) 718-7000.

What is Boulder Plastic Surgery Prof LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Boulder Plastic Surgery Prof LLC was last updated on December 15, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.