NPIMap

Organization Active NPI

Boulder Community Health

Doing business as Community Medical Assoc of BCH

  • Primary Care Clinic/Center
  • Longmont, CO
National Provider Identifier
1083260715
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BOULDER COMMUNITY HEALTH
Doing business as
Community Medical Assoc of BCH
Practice address
2101 Ken Pratt Blvd Ste 104a
Longmont, CO 80501-6568
Phone
(303) 415-4155
Fax
(303) 776-3109
NPI assigned
Aug 19, 2019
Last updated
May 19, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BOULDER COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Authorized official

Name
William A Munson Jr.
Title
VP, Cfo
Phone
(303) 415-7433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2101 Ken Pratt Blvd Ste 104a
Longmont, CO 80501-6568

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-4155

Other names 2

  • Community Medical Assoc of BCH Doing business as
  • Frontier Internal Medicine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000284 CO Part B Supplier - Clinic/Group Practice 6800707233 Receives reassigned benefits from 316 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Erie, CO; Superior, CO; Longmont, CO; Lafayette, CO; Boulder, CO

National Provider Directory

National Provider Directory
Tax ID family
Boulder Community Hospi83 organizations share this tax ID, including this one
Part of
Boulder Community Hospi

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

2101 Ken Pratt Blvd
Ste 104
Longmont, CO 80501
Phone (303) 776-1532

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1083260715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9049",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803019049",
            "telephone_number": "303-415-4155",
            "fax_number": "303-776-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 KEN PRATT BLVD STE 104A",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016568",
            "telephone_number": "303-415-4155",
            "fax_number": "303-776-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOULDER COMMUNITY HEALTH",
        "enumeration_date": "2019-08-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP, CFO",
        "authorized_official_telephone_number": "303-415-7433",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Medical Assoc of BCH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Frontier Internal Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Frontier Internal Medicine",
            "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 May 19, 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.