NPIMap

Organization Active NPI

Compassionate Concierge Physicians, LLC

  • Family Medicine Physician
  • Longmont, CO
National Provider Identifier
1003452301
Registry record updated Aug 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMPASSIONATE CONCIERGE PHYSICIANS, LLC
Practice address
5390 Saint Vrain Rd
Longmont, CO 80503-9307
Phone
(720) 986-0850
NPI assigned
Nov 21, 2019
Organization subpart
Yes
Parent organization
COMPASSIONATE CONCIERGE PHYSICIANS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kirk Ernest Mitchell, MDNPI 1811149685
Title
Owner
Phone
(303) 859-9722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

5390 Saint Vrain Rd
Longmont, CO 80503-9307

Mailing address

5390 Saint Vrain Rd
Longmont, CO 80503-9307
Phone (720) 986-0850

Other names 1

  • Compassionate Concierge Physicians - Wound Grafts Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY, ID3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20200117001835 CO Part B Supplier - Clinic/Group Practice 4284069378 Receives reassigned benefits from 5 practitioners
Practice locations: Longmont, CO; Parker, CO; Northglenn, CO; Fort Collins, CO; Denver, CO; Centennial, CO
O20230928002666 WY Part B Supplier - Clinic/Group Practice 4284069378 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Casper, WY; Cheyenne, WY; Lander, WY; Laramie, WY; Sheridan, WY
O20250331002019 ID Part B Supplier - Clinic/Group Practice 4284069378 Receives reassigned benefits from 3 practitioners
Practice locations: Blackfoot, ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Compassionate Concierge Physicians LLC

Locations

1551 Professional Ln
Unit 102
Longmont, CO 80501

1551 Professional Ln
Ste 102
Longmont, CO 80501
Phone (720) 986-0850

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691798400000",
    "number": "1003452301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5390 SAINT VRAIN RD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805039307",
            "telephone_number": "720-986-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5390 SAINT VRAIN RD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805039307",
            "telephone_number": "720-986-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE CONCIERGE PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMPASSIONATE CONCIERGE PHYSICIANS, LLC",
        "enumeration_date": "2019-11-21",
        "last_updated": "2023-08-12",
        "certification_date": "2023-08-12",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "ERNEST",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-859-9722",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassionate Concierge Physicians - Wound Grafts",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.