Active NPI
North Fork Medical Clinic PC
- Family Medicine Physician
- Paonia, CO
National Provider Identifier
1215050489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- NORTH FORK MEDICAL CLINIC PC
- Practice address
- 225 Minnesota Ave
Paonia, CO 81428 - Phone
- (970) 527-4103
- Fax
- (970) 527-5171
- NPI assigned
- Apr 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Timothy C. Meilner, MD
- Title
- Owner, Authorized Official
- Phone
- (970) 527-4103
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
225 Minnesota Ave
Paonia, CO 81428
Mailing address
PO Box 47
Paonia, CO 81428-0047
Phone (970) 527-4103
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17380863 | Medicaid | CO | |
| 187276700 | Other | DEPT OF LABOR |
National Provider Directory
National Provider DirectoryLocations
310 E BRG St
Hotchkiss, CO 81419
Phone (970) 872-3121
310 E BRG St
Hotchkiss, CO 81419
Phone (970) 872-3121
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Paonia, CO
- NPI 1205967478
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Delta, CO
- NPI 1427139393
Family Medicine
-
- Nurse Practitioner
- Gallup, NM
- NPI 1962421347
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1457395200000",
"number": "1215050489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 47",
"city": "PAONIA",
"state": "CO",
"postal_code": "814280047",
"telephone_number": "970-527-4103",
"fax_number": "970-527-5171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 MINNESOTA AVE",
"city": "PAONIA",
"state": "CO",
"postal_code": "81428",
"telephone_number": "970-527-4103",
"fax_number": "970-527-5171"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH FORK MEDICAL CLINIC PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-10",
"last_updated": "2016-03-08",
"status": "A",
"authorized_official_last_name": "MEILNER",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "C.",
"authorized_official_title_or_position": "OWNER, AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "970-527-4103",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "17380863",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR",
"identifier": "187276700",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Paonia, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.