OrganizationActive
Intermountain Medical Group Denver, LLC
NPI 1992313373 · Family Medicine Physician · Lakewood, CO
Provider details
- NPI number
- 1992313373
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Intermountain Front Range, Inc.
- Organization subpart
- Yes
- Authorized official
- Jon Mcdaniel, Vp of Finance(303) 272-0231
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Occupational Medicine Physician2083X0100X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12790 W Alameda Pkwy Ste a
Lakewood, CO 80228-2850
Phone: (303) 403-6350
Fax: (303) 403-6372
Street-level locationGet directions
Mailing address
500 Eldorado Blvd Ste 6300
Broomfield, CO 80021-3422
Other names (DBA / former)
- Doing business as
- Green Mountain Clinic - Primary Care
Registry dates
- Enumerated
- 2020-07-21
- Last updated
- 2024-06-28
- Certified
- 2024-06-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.