Organization · NPI-2

Alpine Medical Group Colorado PLLC

Family Medicine · Centennial, CO

NPI number1992639074

StatusActive

Last updated in NPPESSep 17, 2026

Details

NPI: 1992639074
Entity type: Organization (NPI-2)
Legal business name: Alpine Medical Group Colorado PLLC
Organization subpart: No
Enumeration date: Jun 11, 2026
Certification date: Sep 17, 2026
Last updated: Sep 17, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	–	–	Yes
207R00000X	Internal Medicine	–	–

Other names

South Centennial Primary Care (Other Name)

Practice location

13111 E Briarwood Ave Ste 300
Centennial, CO 80112-3913

Phone 303-680-9150 · Fax 303-680-9149

Mailing address

999 17th St Ste 500
Denver, CO 80202-2728

Phone 956-468-2999 · Fax 956-468-2997

Authorized official

Tracey J Baughey
Credentialing Director
9564682999

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