COLORADO MOUNTAIN MEDICAL, LLC (NPI# 1730747445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730747445 |
| Entity Type | Organization |
| Organization Name | COLORADO MOUNTAIN MEDICAL, LLC |
| Other Organization Name | COLORADO MOUNTAIN MEDICAL, LLC |
| Practice Address |
50 Buck Creek Road, Suite 200 Avon CO 81620 |
| Mailing Address |
Po Box 6347 Eagle CO 81631-0018 |
| Practice Telephone | 9709266340 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-09-06 |
| Authorized Official Name | HAROLD T DUPPER (SVP FINANCE AND CFO) |
| Authorized Official Telephone | 9704797272 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Colorado Mountain Medical, LLC | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 181 W Meadow Dr, Vail, CO 816575242 | 9704762451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093328320 | Colorado Mountain Medical, LLC | Counselor | 429 Edwards Access Rd Unit A207, Edwards, CO 81632-5559 | 2020-08-26 |
| 1073139267 | Colorado Mountain Medical, LLC | Internal Medicine | 323 West Main Street, Suite 101, Frisco, CO 80443 | 2020-06-23 |
| 1467078014 | Colorado Mountain Medical, LLC | Clinic/Center | 108 S Frontage Rd W Ste 101, Vail, CO 81657-5087 | 2020-06-19 |
| 1598381154 | Colorado Mountain Medical, LLC | Internal Medicine | 322 Beard Creek Rd Ste 1300, Edwards, CO 81632-6426 | 2020-06-19 |
| 1063038073 | Colorado Mountain Medical, LLC | Counselor | 230 Chapel Place, Avon, CO 81620 | 2020-06-25 |
| 1215553227 | Colorado Mountain Medical, LLC | Counselor | 230 Chapel Place, Avon, CO 81620 | 2020-06-25 |
| 1215553409 | Colorado Mountain Medical, LLC | Dermatology | 377 Sylvan Lake Road, Suite 210, Eagle, CO 81631 | 2020-06-23 |
| 1417573619 | Colorado Mountain Medical, LLC | Clinic/Center | 377 Sylvan Lake Road, Suite 210, Eagle, CO 81631 | 2020-06-23 |
| 1508482159 | Colorado Mountain Medical, LLC | Internal Medicine | 108 S Frontage Rd W Ste 101, Vail, CO 81657-5087 | 2020-06-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Colorado Mountain Medical, LLC | 318 Broadway Street, Eagle, CO 81631 |
| Street Address |
50 BUCK CREEK ROAD, SUITE 200 |
| City | AVON |
| State | CO |
| Zip Code | 81620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316555386 | Comfort of Your Home Psychiatry | Nurse Practitioner | 175 Hurd Lane, Unit 3212, Avon, CO 81620 | 2020-07-16 |
| 1467076182 | Melina Bjornson | Dentist | 50 Buck Creek Rd #305, Avon, CO 81620 | 2020-05-29 |
| 1598391971 | Jennifer Arens | Acupuncturist | 2170 A Long Spur, Avon, CO 81620 | 2020-03-18 |
| 1093361842 | Vail Clinic, Inc. | Clinic/Center | 1280 Village Rd, Avon, CO 81620 | 2019-08-16 |
| 1295381390 | Vail Clinic, Inc. | Clinic/Center | 126 Riverfront Lane, Suite 101, Avon, CO 81620 | 2019-08-14 |
| 1891358164 | Mary Elizabeth Harper | Pharmacist | 171 Yodder Ave, Avon, CO 81620 | 2019-04-22 |
| 1679036933 | Sean Thomas Veilleux | Pharmacist | 171 Yoder Ave, Avon, CO 81620 | 2019-04-12 |
| 1447727656 | Casey Aberth | Speech-Language Pathologist | 998 W Beaver Creek Blvd, 311, Avon, CO 81620 | 2018-10-25 |
| 1063924447 | Diana Hellestrae Marshall | Massage Therapist | Ascent Physical Therapy, 90 Lake St, Avon, CO 81620 | 2017-10-25 |
| 1346750759 | Matthew Razo | Massage Therapist | 150 E. Beaver Creek Blvd. #204, Avon, CO 81620 | 2017-10-11 |
| Find all providers in zip 81620 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578006896 | Richard Salmon | Family Medicine | 5 Hawks Rdg, Avon, CT 06001-4417 | 2016-11-19 |
| 1386095719 | Stephanie L Reynolds | Family Medicine | 6845 E Us Highway 36 Ste 600, Avon, IN 46123-8132 | 2016-06-27 |
| 1932555844 | Gal Marcan | Family Medicine | 1351 Ronald Reagan Pkwy Ste B, Avon, IN 46123 | 2016-05-10 |
| 1992169700 | Meredith Marie Larson | Family Medicine | 301 Satori Pkwy Ste 200, Avon, IN 46123-6407 | 2016-04-07 |
| 1831486547 | Michael D Buckwalter | Family Medicine | 6845 East Us Highway 36, Ste 600, Avon, IN 46123-8123 | 2011-07-01 |
| 1518096593 | University Primary Care Practices, Inc. | Family Medicine | 1480 Center Rd Ste A, Avon, OH 44011-1239 | 2007-03-05 |
| 1508959487 | Andrew M Cougill | Family Medicine | 1115 N. Ronald Reagan Parkway, Suite 100, Avon, IN 46123-6913 | 2006-10-02 |
| 1790893832 | David Michael Fesak | Family Medicine | 1250 Bur Oak Ct, Avon, IN 46123-9476 | 2006-08-28 |
| 1073526919 | Robert A Rothenberg | Family Medicine | 21 Arts Center Court, Avon, CT 06001-3680 | 2006-08-14 |
| 1669407409 | Suzanne R. Cole | Family Medicine | 8d Canal Ct, Avon, CT 06001-3747 | 2006-07-11 |
| Find all providers in AVON | ||||
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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.