NPIMap

Organization Active NPI

St Mary's Hospital and Medical Center, Inc

Doing business as St. Mary's Family Medicine Clinic

  • Family Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1093338840
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST MARY'S HOSPITAL AND MEDICAL CENTER, INC
Doing business as
St. Mary's Family Medicine Clinic
Practice address
2698 Patterson Rd Unit 42
Grand Junction, CO 81506-8818
Phone
(970) 298-2800
Fax
(970) 298-6902
NPI assigned
May 27, 2020
Last updated
Jan 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Authorized official

Name
Terri L Chinn
Title
VP of Finance
Phone
(970) 298-2020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X

Addresses

Primary practice location

2698 Patterson Rd Unit 42
Grand Junction, CO 81506-8818

Mailing address

2698 Patterson Rd Unit 42
Grand Junction, CO 81506-8818
Phone (970) 298-2800

Other names 1

  • St. Mary's Family Medicine Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000149 CO Part B Supplier - Clinic/Group Practice 1557267069 Receives reassigned benefits from 137 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO

Other NPIs on the same Medicare enrollment 6

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2074370St Mary's Family Medicine Clinic2698 Patterson Rd, Entrance 42, Grand Junction, CO 81506Provider-performed microscopyMar 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Colorado West ER Physic8 organizations share this tax ID, including this one
Part of
Sisters of Charity of Leavenworth Health System Inc

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2698 Patterson Rd
#42
Grand Junction, CO 81506
Phone (970) 298-2800

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1093338840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 PATTERSON RD UNIT 42",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068818",
            "telephone_number": "970-298-2800",
            "fax_number": "970-298-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 PATTERSON RD UNIT 42",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068818",
            "telephone_number": "970-298-2800",
            "fax_number": "970-298-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY'S HOSPITAL AND MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC",
        "enumeration_date": "2020-05-27",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "CHINN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "970-298-2020"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Mary's Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.