NPIMap

Organization Active NPI

Rocky Mountain Plastic Surgery P.C.

  • Specialist
  • Glenwood Springs, CO
National Provider Identifier
1104959956
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
36386 Issued in CO
Legal business name
ROCKY MOUNTAIN PLASTIC SURGERY P.C.
Practice address
1830 Blake Ave
Suite 207
Glenwood Springs, CO 81601-4261
Phone
(970) 945-1144
Fax
(970) 945-9138
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
Katie Dehm
Title
Manager
Phone
(970) 945-1144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 36386 CO Primary

Addresses

Primary practice location

1830 Blake Ave
Suite 207
Glenwood Springs, CO 81601-4261

Mailing address

1830 Blake Ave
Suite 207
Glenwood Springs, CO 81601-4261
Phone (970) 945-1144

Other identifiers 1

IdentifierTypeStateIssuer
15728382MedicaidCO

National Provider Directory

National Provider Directory

Locations

15 Market St
Unit B
Glenwood Springs, CO 81601
Phone (970) 945-1144

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1104959956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "address_2": "SUITE 207",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014261",
            "telephone_number": "970-945-1144",
            "fax_number": "970-945-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "address_2": "SUITE 207",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014261",
            "telephone_number": "970-945-1144",
            "fax_number": "970-945-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN PLASTIC SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "DEHM",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "970-945-1144"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CO",
            "license": "36386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15728382",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.