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BRECKENRIDGE MEDICAL CLINIC LLC NPI 1376682740


NPI Information

NPI: 1376682740
Provider Name: BRECKENRIDGE MEDICAL CLINIC, LLC

Doing Business As: BRECKENRIDGE MEDICAL CLINIC, LLC

Classification: Emergency Medicine - 207P00000X
Entity Type: Organization

CLIA Number: 06D0709238

Address:
555 SOUTH PARK AVENUE
PLAZA 2
BRECKENRIDGE, CO
ZIP 80424
Phone: (970) 453-1010
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BRECKENRIDGE MEDICAL CLINIC, LLC is an emergency medicine in Breckenridge, CO. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. BRECKENRIDGE MEDICAL CLINIC, LLC NPI is 1376682740. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Breckenridge Medical Clinic, Llc.

The provider's business location address is:

555 SOUTH PARK AVENUE
PLAZA 2
BRECKENRIDGE, CO
ZIP 80424
Phone: (970) 453-1010

The provider's authorized official is Paul Chodowski .
The authorized official title is President/ceo and has the following contact phone number (970) 668-2852.

The CLIA number assigned to this NPI record is 06D0709238 - community clinic with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/5/2007 and was last updated on 10/20/2009.


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 MedicineNo
2207P00000XEmergency 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
1C808784MEDICARE PINCOLORADO

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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