St Mary'S Hospital and Medical Center, Inc

Organization Active NPI Family Medicine Physician · Grand Junction, CO

NPI 1093338840 · NPPES record last updated Jan 3, 2024

Key facts

NPI
1093338840
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
ST MARY'S HOSPITAL AND MEDICAL CENTER, INC
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
Organization subpart
Yes
Parent organization (as reported)
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC

Authorized official

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

Other NPIs on the same Medicare enrollment 6

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

Corporate family (same tax ID) 7

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

Practitioners 40

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

View all 40

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2074370St Mary'S Family Medicine Clinic
2698 Patterson Rd, Entrance 42, Grand Junction, CO 81506
Provider-performed microscopyMar 6, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

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

National Provider Directory

Tax ID family
Colorado West ER Physic (8 organizations share this tax ID)
Part of
Sisters of Charity of Leavenworth Health System Inc

Locations

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Sports Medicine (Family Medicine) Physician
Group: 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

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

Other providers in Grand Junction, CO

All providers in Grand Junction, CO · Family Medicine Physician in Colorado

Sources for this page

Verify at the official NPI Registry.