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COLORADO MOUNTAIN MEDICAL PC NPI 1083675102


NPI Information

NPI: 1083675102
Provider Name: COLORADO MOUNTAIN MEDICAL, PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 06D2174042

Address:
50 BUCK CREEK ROAD
SUITE 200
AVON, CO
ZIP 81620
Phone: (970) 926-6340
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COLORADO MOUNTAIN MEDICAL, PC is a family medicine in Avon, CO. The provider is 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. COLORADO MOUNTAIN MEDICAL, PC NPI is 1083675102. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

50 BUCK CREEK ROAD
SUITE 200
AVON, CO
ZIP 81620
Phone: (970) 926-6340
Fax: (970) 926-6348

The provider's authorized official is Janet Engle .
The authorized official title is President and has the following contact phone number (970) 926-6340.

The CLIA number assigned to this NPI record is 06D2174042 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2006 and was last updated on 9/29/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2207RG0100XInternal MedicineGastroenterologyNo
3207V00000XObstetrics & GynecologyNo
4208000000XPediatricsNo
5207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CH340-8MEDICARE PINCOLORADO
204005617MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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