NPIMap

Organization Active NPI

Animas Surgical Hospital, LLC

Doing business as Animas Family Medicine

  • Family Medicine Physician
  • Durango, CO
National Provider Identifier
1235313693
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0109 Issued in CO
Legal business name
ANIMAS SURGICAL HOSPITAL, LLC
Doing business as
Animas Family Medicine
Practice address
575 Rivergate Lane
#105
Durango, CO 81301
Phone
(970) 385-2344
Fax
(405) 841-9354
NPI assigned
Dec 20, 2007
Last updated
Feb 8, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ANIMAS SURGICAL HOSPITAL, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0109 CO Primary

Addresses

Primary practice location

575 Rivergate Lane
#105
Durango, CO 81301

Mailing address

6128 S Lyncrest Ave
Sioux Falls, SD 57108-2560
Phone (888) 955-0501

Other names 1

  • Animas Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Animas Surgical Hospital LL6 organizations share this tax ID, including this one
Part of
Animas Surgical Hospital LL

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1235313693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6128 S LYNCREST AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082560",
            "telephone_number": "888-955-0501",
            "fax_number": "605-274-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE LANE",
            "address_2": "#105",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81301",
            "telephone_number": "970-385-2344",
            "fax_number": "405-841-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANIMAS SURGICAL HOSPITAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANIMAS SURGICAL HOSPITAL, LLC",
        "enumeration_date": "2007-12-20",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "0109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Animas Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Animas Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.