DAVITA MEDICAL GROUP
NPI 1316480783
General Practice in Fountain, CO

Active since December 02, 2016
5115 FONTAINE BLVD, FOUNTAIN, CO 80817(719) 392-2000(719) 392-6937 Get Directions Write a Review

NPPES record last updated: August 20, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 20, 2019, Sep 22, 2017 (2 updates tracked since 2017).

  • Organization
  • General Practice

About DAVITA MEDICAL GROUP

This page provides the complete NPI Profile along with additional information for Davita Medical Group, a primary care provider established in Fountain, Colorado operating as a General Practice. The healthcare provider is registered in the NPI registry with number 1316480783 assigned on December 2016. The practitioner's primary taxonomy code is 208D00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. Davita Medical Group operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Davita Medical Group. The authorized official of this NPI record is John G. Liethen (Secretary)

NPI
1316480783 Verify this NPI
Provider Legal Name
OPTUMCARE COLORADO SPRINGS, LLC
Other Organization Name
DAVITA MEDICAL GROUP
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
5115 FONTAINE BLVD FOUNTAIN, CO 80817
Location Phone
(719) 392-2000
Location Fax
(719) 392-6937
Mailing Address
2 S CASCADE AVE STE 140 COLORADO SPRINGS, CO 80903
Mailing Phone
(719) 538-2900
Mailing Fax
(719) 538-2987
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-02-2016
Last Update Date
08-20-2019
Code Navigator

A primary care provider (PCP) like Davita Medical Group sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

General Practice

Taxonomy Code
208D00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JOHN G. LIETHEN

Authorized Official Title
SECRETARY
Authorized Official Phone
(952) 205-6262

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Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Family Medicine
5115 FONTAINE BLVD
FOUNTAIN, CO 80817
Family Medicine
5115 FONTAINE BLVD
FOUNTAIN, CO 80817
Nurse Practitioner (Family)
5115 FONTAINE BLVD
FOUNTAIN, CO 80817
Nurse Practitioner (Family)
5115 FONTAINE BLVD
FOUNTAIN, CO 80817
Nurse Practitioner (Psychiatric/Mental Health)
5115 FONTAINE BLVD
FOUNTAIN, CO 80817
Clinic/Center (Primary Care)
5115 FONTAINE BLVD
FOUNTAIN, CO 80817
Nurse Practitioner (Family)
5115 FONTAINE BLVD
FOUNTAIN, CO 80817

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316480783, enumerated as an "organization" on December 02, 2016.

The provider is located at 5115 FONTAINE BLVD FOUNTAIN, CO 80817 and the phone number is (719) 392-2000.

General Practice with taxonomy code 208D00000X.