Advanced Alpine Dermatology Prof LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

42483 Issued in CO

Legal business name

ADVANCED ALPINE DERMATOLOGY PROF LLC

Practice address

1136 Alpine Ave
Suite 310
Boulder, CO 80304-3405

Phone

(303) 449-3500

NPI assigned

May 19, 2008

Last updated

May 19, 2008By 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

Peter Bachmann, M.D.NPI 1992702161

Title

Owner

Phone

(303) 449-3500

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Peter Bachmann, MD

  • Dermatology Physician
  • Longmont, CO
  • NPI 1992702161
  NPD (past) Authorized official

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1225295199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 ALPINE AVE",
            "address_2": "SUITE 310",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043405",
            "telephone_number": "303-449-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 ALPINE AVE",
            "address_2": "SUITE 310",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043405",
            "telephone_number": "303-449-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ALPINE DERMATOLOGY PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "BACHMANN",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-449-3500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "42483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98428721",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.