NPIMap

Organization Active NPI

Catholic Health Initiatives Colorado

Doing business as Prid PC Idaho Springs

  • Family Medicine Physician
  • Idaho Springs, CO
National Provider Identifier
1134730757
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CATHOLIC HEALTH INITIATIVES COLORADO
Doing business as
Prid PC Idaho Springs
Practice address
1969 Miner Street
Idaho Springs, CO 80452-0000
Phone
(303) 649-3690
Fax
(303) 649-3691
NPI assigned
Aug 17, 2020
Last updated
Jun 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Mrs. Angela Jo Skinner
Title
Administrator Oma
Phone
(720) 667-7283

Specialties & licenses 1

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

Addresses

Primary practice location

1969 Miner Street
Idaho Springs, CO 80452-0000

Mailing address

PO Box 800022
Kansas City, MO 64180-0022
Phone (800) 953-0104

Other names 2

  • PRID PC IDAHO SPRINGS Doing business as
  • CMG Primary Care Idaho Springs Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000462 CO Part B Supplier - Clinic/Group Practice 8022927342 Receives reassigned benefits from 1,310 practitioners
This NPI is an additional NPI on the enrollment

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
06D2132269Commonspirit Primary Care Idaho Springs1969 Miner St, Idaho Springs, CO 80452Certificate of waiverJun 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Anthony Family Medic321 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

1 Mercado St
Ste 202
Durango, CO 81301
Phone (970) 247-5362

360 Peak One Dr
Ste 260
Frisco, CO 80443
Phone (970) 668-5584

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1134730757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800022",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641800022",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 MINER STREET",
            "city": "IDAHO SPRINGS",
            "state": "CO",
            "postal_code": "804520000",
            "telephone_number": "303-649-3690",
            "fax_number": "303-649-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC HEALTH INITIATIVES COLORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR OMA",
        "authorized_official_telephone_number": "720-667-7283",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRID PC IDAHO SPRINGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CMG Primary Care Idaho Springs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Idaho Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.