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RIVERGATE ORTHOPEDICS AND ANIMAS UROLOGY PC NPI 1629481254


NPI Information

NPI: 1629481254
Provider Name: RIVERGATE ORTHOPEDICS AND ANIMAS UROLOGY, PC
Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 06D0518860

Address:
555 RIVERGATE STE B1-106
DURANGO, CO
ZIP 81301
Phone: (970) 247-0508
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RIVERGATE ORTHOPEDICS AND ANIMAS UROLOGY, PC is an urology in Durango, CO. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. RIVERGATE ORTHOPEDICS AND ANIMAS UROLOGY, PC NPI is 1629481254. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

555 RIVERGATE STE B1-106
DURANGO, CO
ZIP 81301-478
Phone: (970) 247-0508

The provider's authorized official is Mark Robert Forrest .
The authorized official title is Owner/urologist and has the following contact phone number (970) 247-0508.

The CLIA number assigned to this NPI record is 06D0518860 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/11/2014 and was last updated on 11/26/2014.


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
1208800000XUrology41391COLORADOYes

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
11265469340MEDICARE UPIN

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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