TRAVERSE BAY MEDICAL, PC (NPI# 1124474945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124474945 |
| Entity Type | Organization |
| Organization Name | TRAVERSE BAY MEDICAL, PC |
| Other Organization Name | COLORADO INTEGRATIVE MEDICAL CENTER |
| Practice Address |
1815 Sunshine Ave Longmont CO 80504-2225 |
| Mailing Address |
2575 Park Ln Ste 101-b Lafayette CO 80026-3200 |
| Practice Telephone | 3037229000 |
| Mailing Telephone | 3037229000 |
| Mailing Fax Number | 8448001478 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-08-01 |
| Authorized Official Name | DR. MARY LOUISE LOUDER (OWNER) |
| Authorized Official Telephone | 3037229000 |
| Authorized Official Credential | D.O |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Colorado Integrative Medical Center | Doing Business As Name - Organization |
| Street Address |
1815 SUNSHINE AVE |
| City | LONGMONT |
| State | CO |
| Zip Code | 80504-2225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548616154 | Carolyn Franklin Baker | Registered Nurse | 1815 Sunshine Ave, Longmont, CO 80504-2225 | 2016-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942776620 | Cinde S Yoho | Social Worker | 9485 County Road 15, Firestone, CO 80504 | 2018-10-19 |
| 1427544881 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 310 Lashley St Ste 109, Longmont, CO 80504 | 2018-07-09 |
| 1962913962 | Melissa Frick | Counselor | 10184 E I-25 Frontage Rd, Firestone, CO 80504 | 2017-10-17 |
| 1558757260 | Firestone Pediatric Dentistry and Orthodontics | Dentist | 8301 Colorado Blvd, Suite 200, Firestone, CO 80504 | 2015-04-09 |
| 1912392671 | Ashley Lerwick | Speech-Language Pathologist | 11169 Interstate I25 Frontage Rd, Firestone, CO 80504 | 2015-03-31 |
| 1780077685 | Roger Leon Jorgensen | Ophthalmology | 14222 N 95 Si, Longmont, CO 80504 | 2015-03-17 |
| 1982942090 | Carrie Rose Fitzekam | Technician | 712 Tanagers Circle, Longmont, CO 80504 | 2013-01-24 |
| 1003166976 | Jennifer Lynn Mcnerney | Speech-Language Pathologist | 8197 Miller Dr, Frederick, CO 80504 | 2012-09-18 |
| 1821343450 | Allison Luellen | Physician Assistant | 8350 Colorado Blvd, Suite 160, Firestone, CO 80504 | 2012-07-19 |
| 1609132109 | Abby Elizabeth Bohall | Speech-Language Pathologist | 5132 Mt Buchanan Ave, Frederick, CO 80504 | 2012-04-09 |
| Find all providers in zip 80504 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1992988828 | Mark W. Hinman, Md, LLC | Clinic/Center | 1350 Tulip St, Longmont, CO 80501-3140 | 2007-12-13 |
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| 1992330500 | Quality Medical Clinic LLC | Clinic/Center | 3604 Galley Rd Ste 201, Colorado Springs, CO 80909-4301 | 2020-03-04 |
| 1992344659 | Metropolitan General Practice PC | Clinic/Center | 7400 E Crestline Cir Ste 105, Greenwood Village, CO 80111-3656 | 2019-12-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.