Richard Grossman, MD, MPH

Key facts

NPI

1265448989

Entity type

Individual (NPI type 1)

Primary specialty

Obstetrics & Gynecology Physician 207V00000X

License

20447 (CO)

Practice address

1 Mercado St
Suite 105
Durango, CO 81301-7300

Phone

(970) 382-8800

Fax

(970) 382-0122

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Richard a Grossman Specialist · Durango, CO · NPI 1194989913
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 16, 2007.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1265448989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "SUITE 105",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017300",
            "telephone_number": "970-382-8800",
            "fax_number": "970-382-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "SUITE 105",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017300",
            "telephone_number": "970-382-8800",
            "fax_number": "970-382-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "70-135",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "20447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Durango, CO · Obstetrics & Gynecology Physician in Colorado