Dynamic Athlete PLLC
NPI 1841986494ActiveOrganization· Internal Medicine, Sports Medicine· Boulder, CO
Internal Medicine, Sports Medicine in Boulder, Colorado, registered in NPPES in April 2023. The authorized official on file is Nicole Allison, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1841986494 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 17, 2023 |
| Last updated in NPPES | Jan 10, 2025 |
| Certified by provider | Jan 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Sports Medicine Primary | 207RS0010X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CO) |
|---|
Other Internal Medicine, Sports Medicine providers in Boulder
- 1477039907
- 1306136288
- 1346537370
All Internal Medicine, Sports Medicine providers in Colorado →