Durango Urgent Care LLC
Organization Active NPI Urgent Care Clinic/Center · Durango, CO
NPI 1154354512 · NPPES record last updated Mar 12, 2024
Key facts
- NPI
- 1154354512
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- DURANGO URGENT CARE LLC
- Practice address
- 2577 Main Ave
Durango, CO 81301-5919 - Phone
- (970) 247-8382
- Fax
- (970) 259-4403
- NPI assigned
- Jul 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Bryan Vincent
- Title
- Authorized Official
- Phone
- (970) 247-8382
Member organizations 1
Practitioners 23
-
Charles Jason Alexander, PT, DPT
-
Eli S Mauksch, DNP
-
Benjamin Donald Reetz, PA-C
-
Shawnee Bradley, FNP-BC
-
Jenny Hargrove, M.D.
-
Jessica Martinez, MPAS
-
Nicholas M Armano, P.A.
-
Patrick Ely, PA
-
Amanda Grace Kiessel, PA-C
-
Nicole Marie Oury, M.D.
-
Mary Alice Rios, PA-C
-
Sara Elizabeth Shively, PA-C
-
Christopher A Stewart, PA-C
-
Wyatt Brown, PA-C
-
Zane Alexander Downs, PA-C
-
Shaina Nawrocki, CFNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D1057840 | Durango Urgent Care, LLC | Registration | Dec 10, 2026 |
| 06D2272405 | Durango Urgent Care, LLC | Certificate of waiver | Nov 20, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070319000364 | CO | Part B Supplier - Clinic/Group Practice | 9335141266 |
Receives reassigned benefits from 22 practitioners Practice locations: Cortez, CO; Durango, CO |
| O20140131001297 | CO | DME Supplier - Physician - General Practice | 9335141266 | Practice locations: Durango, CO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
2577 Main Ave
Durango, CO 81301-5919
Mailing address
2577 Main Ave
Durango, CO 81301-5919
Phone (970) 247-8382
Other practice location 1
10 Purgatory Blvd
Durango, CO 81301
Phone (970) 828-8382
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6720081 | Medicaid | CO |
Other providers in Durango, CO
- Durango Surgicenter, LLC
- Durango Taxi LLC
- Durango Toxicology LLC
- Durango Transportation Inc
- Durango Ultrasound
- Durango Urological Associates PC
- Durango Walk-in Chiropractic
- Carly Duvall
- Ryan Duvall
- Paul D Dvirnak
All providers in Durango, CO · Urgent Care Clinic/Center in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.