Clint B Pitchforth, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

100093 Issued in CO

Practice address

1501 E 3Rd St
Delta, CO 81416-2815

Phone

(970) 874-7681

Fax

(970) 874-6400

NPI assigned

May 11, 2011

Last updated

Mar 11, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Paz Regional Hospital IncGroup PAC ID 1557273356, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• La Paz Regional Hospital Hospital, Parker, AZ, CCN 031317

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• La Paz Regional Hospital Inc

  • Critical Access Hospital
  • Parker, AZ
  • NPI 1053684555
  Medicare reassignment Care Compare group NPD
• Valley Anesthesiology Consultants, Inc.

  • Anesthesiology Physician
  • Phoenix, AZ
  • NPI 1285660704
  Medicare reassignment NPD
• La Paz Regional Hospital Inc

  • Urgent Care Clinic/Center
  • Parker, AZ
  • NPI 1598009029
  NPD
• La Paz Regional Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Parker, AZ
  • NPI 1598038093
  NPD
• Four Corners Anesthesia, P.a.

  • Anesthesiology Physician
  • Farmington, NM
  • NPI 1093758831

  Nurse Anesthetist, Certified Registered

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• La Paz Regional Hospital Inc

  • Critical Access Hospital
  • Parker, AZ
  • NPI 1053684555
  Care Compare affiliation
• La Paz Regional Hospital Inc., Dba Parker Podiatry

  • Podiatrist
  • Parker, AZ
  • NPI 1568875771

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1053603993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10100",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814160008",
            "telephone_number": "970-874-7681",
            "fax_number": "970-874-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 3RD ST",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814162815",
            "telephone_number": "970-874-7681",
            "fax_number": "970-874-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITCHFORTH",
        "first_name": "CLINT",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-11",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA-01147",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "250160",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "100093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NMAAA1472",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25670875",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "634497",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053603993",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69837252",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Phillips, LPC
• Hali Lynn Phillips, MT
• Lauren Claire Phillips
• Valquiria Pierucci, RPH
• Amber Pinnow
• Michelle P Purvis, M.D.
• Rachel N Depuy, MD, PC
• Marvin Guy Raether
• Rosalind R Rafanelli, M.D.
• Cynthia Rapp, EDS

• Certified Registered Nurse Anesthetist in Delta, CO
• Providers in Delta, CO by specialty
• Certified Registered Nurse Anesthetist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.