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GREEN MOUNTAIN CLINIC - PRIMARY CARE
NPI 1992313373
Family Medicine in Lakewood, CO

Active since July 21, 2020CLIA 06D0691762 · Waiver
12790 W ALAMEDA PKWY STE A, LAKEWOOD, CO 80228(303) 403-6350(303) 403-6372 Get Directions Write a Review

NPPES record last updated: June 28, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 28, 2024, Nov 7, 2023, Jul 21, 2020 (3 updates tracked since 2020).

About Green Mountain Clinic - Primary Care NPPES

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

GREEN MOUNTAIN CLINIC - PRIMARY CARE (NPI 1992313373) is a healthcare organization registered as a family medicine in Lakewood, Colorado and active in the NPI registry since July 2020. The organization holds a CLIA Waiver certificate valid through February 4, 2027 and lists Jon Mcdaniel, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1992313373
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameINTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Location Address12790 W ALAMEDA PKWY STE ALakewood, CO 80228-2850
Mailing Address500 Eldorado Blvd Ste 6300Broomfield, CO 80021-3422 · (303) 272-0566
Phone(303) 403-6350
Fax(303) 403-6372
Organization SubpartYesParent: Intermountain Front Range, Inc.
Authorized OfficialJon McdanielVp Of Finance · (303) 272-0231
Enumeration DateJuly 21, 2020
Last NPPES UpdateJune 28, 20243 updates tracked since enumeration
NPPES CertifiedJune 28, 2024
✔ NPI 1992313373 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
12790 W ALAMEDA PKWY STE A, Lakewood, CO 80228
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Other Names 1

Doing Business AsGreen Mountain Clinic - Primary Care

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 06D0691762

Green Mountain Clinic Primary Care · Lakewood, CO
Active · expires Feb 4, 2027
CLIA Number06D0691762
Laboratory TypePhysician Office
Certificate Effective DateFebruary 5, 2025
Certificate Expiration DateFebruary 4, 2027
Laboratory DirectorDr. Edward Shuherk
Laboratory Phone(303) 403-6350
Laboratory LocationGreen Mountain Clinic Primary Care12790 W Alameda Pkwy, Suite A, Lakewood, CO 80228
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 3

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

JOSHUA LUEY MCKEE
Internal Medicine
12790 W ALAMEDA PKWY STE A
LAKEWOOD, CO 80228
Jefferson County (303) 403-6350
CLARENCE V ELLIS MD
Family Medicine
12790 W ALAMEDA PKWY STE A
LAKEWOOD, CO 80228
Jefferson County (303) 403-6350
SUZANNE M BECK DO
Family Medicine
12790 W ALAMEDA PKWY STE A
LAKEWOOD, CO 80228
Jefferson County (303) 403-6350

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 1992313373. It was assigned to this organization in the NPPES registry on July 21, 2020. The provider is doing business as Green Mountain Clinic - Primary Care.

Where is Intermountain Medical Group Denver, LLC located?

Intermountain Medical Group Denver, LLC is located at 12790 W Alameda Pkwy Ste A, Lakewood, CO 80228. The listed phone number is (303) 403-6350.

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 06D0691762) is associated with this NPI, valid through February 4, 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.