BROOMFIELD CLINIC
NPI 1497367213
Family Medicine in Broomfield, CO

Active since August 21, 2020CLIA 06D1051480 · Waiver
12169 SHERIDAN BLVD, BROOMFIELD, CO 80020(303) 603-9400(303) 603-9420 Get Directions Write a Review

NPPES record last updated: June 28, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 28, 2024, Aug 21, 2020 (2 updates tracked since 2020).

About Broomfield Clinic NPPES

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

BROOMFIELD CLINIC (NPI 1497367213) is a healthcare organization registered as a family medicine in Broomfield, Colorado and active in the NPI registry since August 2020. The organization holds a CLIA Waiver certificate valid through January 30, 2027 and lists Jon Mcdaniel, Vp Finance, as its authorized official.

NPPES Registry Identity

NPI1497367213
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameINTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Location Address12169 SHERIDAN BLVDBroomfield, CO 80020-2459
Mailing Address500 Eldorado Blvd Ste 6300Broomfield, CO 80021-3422 · (303) 272-0566
Fax(303) 603-9420
Organization SubpartYesParent: Intermountain Front Range, Inc.
Authorized OfficialJon McdanielVp Finance · (303) 272-0231
Enumeration DateAugust 21, 2020
Last NPPES UpdateJune 28, 20242 updates tracked since enumeration
NPPES CertifiedJune 28, 2024
NPI 1497367213 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPreventive Medicine · Occupational MedicineTaxonomy 2083X0100X
12169 SHERIDAN BLVD, Broomfield, CO 80020

Other Names 3

Doing Business AsBroomfield Clinic
Other NameBroomfield Clinic Occupational Therapy
Other NameBroomfield Clinic Physical Therapy

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

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 06D1051480

Broomfield Clinic · Broomfield, CO
Active · expires Jan 30, 2027
CLIA Number06D1051480
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorDr. Matthew Liebentritt
Laboratory Phone(303) 603-9400
Laboratory LocationBroomfield Clinic12169 Sheridan Blvd, Broomfield, CO 80020
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

Family Medicine
12169 SHERIDAN BLVD
BROOMFIELD, CO 80020
Counselor (Mental Health)
12169 SHERIDAN BLVD
BROOMFIELD, CO 80020
Registered Nurse
12169 SHERIDAN BLVD
BROOMFIELD, CO 80020
Nurse Practitioner (Family)
12169 SHERIDAN BLVD
BROOMFIELD, CO 80020
Physical Therapist
12169 SHERIDAN BLVD
BROOMFIELD, CO 80020
Pharmacist
12169 SHERIDAN BLVD
BROOMFIELD, CO 80020
Family Medicine
12169 SHERIDAN BLVD
BROOMFIELD, CO 80020

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 Intermountain Medical Group Denver, LLC's NPI number?

The NPI number for Intermountain Medical Group Denver, LLC is 1497367213. It was assigned to this organization in the NPPES registry on August 21, 2020. The provider is doing business as Broomfield Clinic. The provider is also known as Broomfield Clinic Occupational Therapy and Broomfield Clinic Physical Therapy.

Where is Intermountain Medical Group Denver, LLC located?

Intermountain Medical Group Denver, LLC is located at 12169 Sheridan Blvd, Broomfield, CO 80020. The listed phone number is (303) 603-9400.

What is Intermountain Medical Group Denver, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Intermountain Medical Group Denver, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D1051480) is associated with this NPI, valid through January 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Intermountain Medical Group Denver, LLC was last updated on June 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.