DAVITA MEDICAL GROUP
NPI 1316480783
General Practice in Fountain, CO

Q: What is Optumcare Colorado Springs, LLC's NPI number?

The NPI number for Optumcare Colorado Springs, LLC is 1316480783. It was assigned to this organization in the NPPES registry on December 2, 2016. The provider is doing business as Davita Medical Group.

Q: What is Optumcare Colorado Springs, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

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: August 09, 2026.

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

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About Davita Medical Group NPPES

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

DAVITA MEDICAL GROUP (NPI 1316480783) is a healthcare organization registered as a general practice in Fountain, Colorado and active in the NPI registry since December 2016. The organization lists John G. Liethen, Secretary, as its authorized official.

NPPES Registry Identity

NPI1316480783

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameOPTUMCARE COLORADO SPRINGS, LLC

Location Address5115 FONTAINE BLVDFountain, CO 80817-1061

Mailing Address2 S Cascade Ave, Ste 140Colorado Springs, CO 80903-1624 · (719) 538-2900 · Fax (719) 538-2987

Phone(719) 392-2000

Fax(719) 392-6937

Organization SubpartNo

Authorized OfficialJohn G. LiethenSecretary · (952) 205-6262

Enumeration DateDecember 2, 2016

Last NPPES UpdateAugust 20, 20192 updates tracked since enumeration

✔ NPI 1316480783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

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

5115 FONTAINE BLVD, Fountain, CO 80817

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Other Names 1

Doing Business AsDavita Medical Group

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

Other Providers at the Same Location NPPES 7

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

DR. THOMAS G JOHNSON MD

Family Medicine