TIMBERLINE CLINIC INC. NPI 1861618191

NPI Information

NPI: 1861618191
Provider Name: TIMBERLINE CLINIC, INC.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
980 MAIN ST.
FAIRPLAY, CO
ZIP 80440
Phone: (719) 836-3455
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TIMBERLINE CLINIC, INC. is a family nurse practitioner in Fairplay, CO. TIMBERLINE CLINIC, INC. NPI is 1861618191. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

980 MAIN ST.
FAIRPLAY, CO
ZIP 80440-723
Phone: (719) 836-3455
Fax: (719) 836-1792

The provider's authorized official is Kathryn L. Young .
The authorized official title is President and has the following contact phone number (719) 836-3455.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 5/18/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	43262	COLORADO	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01	OTHER	COLORADO	CO PACIFICARE
2	=========	OTHER		CHAMPUS WEST REGION
3	YO634320	OTHER	COLORADO	CO BLUE SHIELD
4	R19791	MEDICARE UPIN	COLORADO
5	76106	MEDICARE ID-TYPE UNSPECIFIED	COLORADO
6	B2738	MEDICARE ID-TYPE UNSPECIFIED	COLORADO
7	04008850	MEDICAID	COLORADO
8	A=========001	OTHER	COLORADO	ROCKY MTN HMO
9	E41948	MEDICARE UPIN	COLORADO
10	01219609	MEDICAID	COLORADO
11	500000326	OTHER	COLORADO	RAILROAD MEDICARE
12	SH29090	OTHER	COLORADO	CO BLUE SHIELD
13	07100753	MEDICAID	COLORADO

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

NPI Synchronization or Removal

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