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COMMUNITY MEDICAL GROUP LLC NPI 1114564952


NPI Information

NPI: 1114564952
Provider Name: COMMUNITY MEDICAL GROUP, LLC

Doing Business As: GRAND VALLEY PRIMARY CARE III

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 06D2074219

Address:
2478 PATTERSON RD STE 27
GRAND JCT, CO
ZIP 81505
Phone: (970) 644-4300
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COMMUNITY MEDICAL GROUP, LLC is a family medicine in Grand Jct, 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. COMMUNITY MEDICAL GROUP, LLC NPI is 1114564952. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Grand Valley Primary Care Iii.

The provider's business location address is:

2478 PATTERSON RD STE 27
GRAND JCT, CO
ZIP 81505-606
Phone: (970) 644-4300
Fax: (970) 263-4323

The provider's authorized official is Christian Thomas .
The authorized official title is President/ceo and has the following contact phone number (970) 644-3011.

The CLIA number assigned to this NPI record is 06D2074219 - ancillary testing site in health care center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/27/2019 and was last updated on 4/12/2021.


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
1207Q00000XFamily 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
19000159153MEDICAIDCOLORADO

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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