NPIMap

Organization Active NPI

Community Medical Group, LLC

  • Specialist
  • Grand JCT, CO
National Provider Identifier
1265079545
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COMMUNITY MEDICAL GROUP, LLC
Practice address
688 23 1/2 Road
Suite 301
Grand JCT, CO 81505-8904
Phone
(970) 644-4030
Fax
(970) 644-3914
NPI assigned
Dec 5, 2019
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Christian Thomas
Title
President/Ceo
Phone
(970) 644-3011

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151222000695 CO Part B Supplier - Clinic/Group Practice 1052612785 Receives reassigned benefits from 123 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO; Meeker, CO; Palisade, CO; Rangely, CO; Grand JCT, CO; Fruita, CO; Delta, CO; Clifton, CO

National Provider Directory

National Provider Directory
Tax ID family
Community Medical Group LLC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

688 23 12 Rd
Ste 301
Grand JCT, CO 81505
Phone (970) 644-4030

2503 Foresight Cir
Ste B
Grand Junction, CO 81505
Phone (970) 644-4030

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X

Addresses

NPPES NPI Registry

Primary practice location

688 23 1/2 Road
Suite 301
Grand JCT, CO 81505-8904

Mailing address

PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 644-4030

Other practice location 1

2503 Foresight Cir Unit B
Grand Junction, CO 81505-1139
Phone (970) 644-4030

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
9000190007MedicaidCO

Other names 1

NPPES NPI Registry
  • Grand Valley Cardiology Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 31, 2024.

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1265079545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-644-4030",
            "fax_number": "970-644-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 23 1/2 ROAD",
            "address_2": "SUITE 301",
            "city": "GRAND JCT",
            "state": "CO",
            "postal_code": "815058904",
            "telephone_number": "970-644-4030",
            "fax_number": "970-644-3914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2503 Foresight Cir Unit B",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815051139",
            "country_code": "US",
            "telephone_number": "970-644-4030",
            "fax_number": "970-644-3914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-05",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "970-644-3011"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000190007",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Valley Cardiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grand Valley Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand JCT, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.