NPIMap

Individual provider Active NPI

Todd Anthony Kinnick, DO

  • Anesthesiology Physician
  • Grand Junction, CO
National Provider Identifier
1265452817
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DR.0044198 Issued in CO
Practice address
1120 Wellington Ave
Suite 206
Grand Junction, CO 81501-6129
Phone
(970) 243-7245
Fax
(970) 241-1308
NPI assigned
Jul 19, 2006
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X DR.0044198 CO Primary

Addresses

Primary practice location

1120 Wellington Ave
Suite 206
Grand Junction, CO 81501-6129

Mailing address

1120 Wellington Ave Ste 206
Grand Junction, CO 81501-6131
Phone (970) 243-7245

Other practice location 1

300 W Ottley Ave
Fruita, CO 81521-2118
Phone (970) 858-3900

Other identifiers 3

IdentifierTypeStateIssuer
T0514MedicaidUT
P00366838OtherRAILROAD MEDICARE
55230059MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060307000315 CO Practitioner - Anesthesiology 6709893308 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants of Western Colorado, PLLCGroup PAC ID 8921995754, 28 clinicians

Practice addresses (Care Compare)

2635 N 7TH St
Grand Junction, CO 81501-8209
Phone (970) 298-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Valley Hospital Association CurrentSince Jun 1, 2019 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients
Lower Valley Hospital Association CurrentSince Jun 1, 2019 Accepting new patients
Anesthesia Consultants of Western Colorado LLC Anesthesiology CurrentSince Jun 1, 2006 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients
Lower Valley Hospital Association Anesthesiology Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients
Lower Valley Hospital Association Past Accepting new patients

Locations

300 W Ottley Ave
Fruita, CO 81521
Phone (970) 858-3900

300 W Ottley Ave
#W
Fruita, CO 81521

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1120 Wellington Ave
Ste 206
Grand Junction, CO 81501
Phone (970) 243-7245

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

Organizations & group practices 8

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1265452817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 WELLINGTON AVE STE 206",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016131",
            "telephone_number": "970-243-7245",
            "fax_number": "970-241-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 WELLINGTON AVE",
            "address_2": "SUITE 206",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016129",
            "telephone_number": "970-243-7245",
            "fax_number": "970-241-1308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Ottley Ave",
            "address_purpose": "LOCATION",
            "city": "Fruita",
            "state": "CO",
            "postal_code": "815212118",
            "country_code": "US",
            "telephone_number": "970-858-3900",
            "fax_number": "970-858-2208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINNICK",
        "first_name": "TODD",
        "middle_name": "ANTHONY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "DR.0044198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T0514",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00366838",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55230059",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.