NPIMap

Organization Active NPI

Cedar Point Health LLC

  • Family Medicine Physician
  • Cedaredge, CO
National Provider Identifier
1265168504
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CEDAR POINT HEALTH LLC
Practice address
255 SW 8TH Ave
Cedaredge, CO 81413-3902
Phone
(970) 249-7751
Fax
(970) 541-9806
NPI assigned
Jul 28, 2022
Last updated
Aug 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Cory Phillips
Title
Ceo
Phone
(970) 249-7751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

255 SW 8TH Ave
Cedaredge, CO 81413-3902

Mailing address

300 S Nevada Ave
Montrose, CO 81401-4273
Phone (970) 249-7751

Other identifiers 1

IdentifierTypeStateIssuer
9000208333MedicaidCO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0519023Cedar Point Health255 SW 8TH Ave, Cedaredge, CO 81413Provider-performed microscopySep 18, 2026

National Provider Directory

National Provider Directory
Tax ID family
Internal Medicine Spec15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1265168504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S NEVADA AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814014273",
            "telephone_number": "970-249-7751",
            "fax_number": "970-541-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 SW 8TH AVE",
            "city": "CEDAREDGE",
            "state": "CO",
            "postal_code": "814133902",
            "telephone_number": "970-249-7751",
            "fax_number": "970-541-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR POINT HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-28",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-249-7751"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000208333",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedaredge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.