Longmont Clinic PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

LONGMONT CLINIC PC

Practice address

1925 W Mountain View Ave
Longmont, CO 80501-3128

Phone

(720) 494-3173

Fax

(720) 494-3107

NPI assigned

May 9, 2006

Last updated

Dec 12, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John P. Stathis, M.D.NPI 1902803174

Title

President, Board of Directors

Phone

(720) 494-3173

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Longmont Clinic Lab

  • Clinical Medical Laboratory
  • Longmont, CO
  • NPI 1619073947
  NPPES parent name

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Stathis, MD

  • Cardiovascular Disease Physician
  • Longmont, CO
  • NPI 1902803174
  Authorized official Same address or phone
• Eva Patricia Gill, MD

  • Infectious Disease Physician
  • Longmont, CO
  • NPI 1376548693
  NPD
• Reginald Guy, MD

  • Internal Medicine Physician
  • Longmont, CO
  • NPI 1528063849
  NPD
• David Burnham, MD

  • Surgery Physician
  • Redlands, CA
  • NPI 1124022538
  NPD
• Kristina Rose Tedeschi, M.D.

  • Obstetrics & Gynecology Physician
  • Lancaster, PA
  • NPI 1194712216
  NPD

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1043269772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 W MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013128",
            "telephone_number": "720-494-3173",
            "fax_number": "720-494-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 W MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013128",
            "telephone_number": "720-494-3173",
            "fax_number": "720-494-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGMONT CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "STATHIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT, BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "720-494-3173",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "44008",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy J Long
• Gail Suzanne Longenecker, DIP LCM
• Longmont Anesthesia Associates, PLLC
• Longmont Braces
• Longmont Clinic Lab
• Longmont Complete Dentistry
• Longmont Dental Care
• Longmont Dental Partners, LLC. (Comfort Dental Longmont)
• Longmont Eyecare, PLLC
• Longmont Family Dental, PLLC

• General Practice Physician in Longmont, CO
• Providers in Longmont, CO by specialty
• General Practice Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.