Trinidad Medical Associates , LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TRINIDAD MEDICAL ASSOCIATES , LLC

Doing business as

n/a

Practice address

400 Benedicta Ave
Suite E
Trinidad, CO 81082-2089

Phone

(719) 845-0627

Fax

(719) 845-0663

NPI assigned

May 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Carlisle, M.D.NPI 1689622920

Title

Owner

Phone

(719) 845-0627

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• n/a Doing business as

Locations

Practitioners 1

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.

• Robert Louis Carlisle, M.D.

  • Family Medicine Physician
  • Pueblo, CO
  • NPI 1689622920
  NPD Authorized official

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144273830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BENEDICTA AVE",
            "address_2": "SUITE E",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822089",
            "telephone_number": "719-845-0627",
            "fax_number": "719-845-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BENEDICTA AVE",
            "address_2": "SUITE E",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822089",
            "telephone_number": "719-845-0627",
            "fax_number": "719-845-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINIDAD MEDICAL ASSOCIATES , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-845-0627",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05638937",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trinidad Assisted Living, LLC (The Legacy at Trinidad)
• Trinidad Autism Awareness
• Trinidad Family Medical Center
• Trinidad Inn Inc
• Trinidad Inn, Inc. (Trinidad Inn Nursing Home)
• Trinidad Pediatric & Adult Therapy Service
• Trinidad Physical Therapy and Sports Medicine Inc
• Trinidad Rehabilitation and Healthcare Center LLC
• Trinidad Rehabilitation and Healthcare Center LLC
• Trinidad Reproductive Healthcare Inc

• Family Medicine Physician in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.