NPIMap

Organization Active NPI

Intermountain Medical Group Grand Junction, LLC

Doing business as SCL Health Medical Group - Heart & Vascular Institute - Vascular

  • Medical Specialty Clinic/Center
  • Grand Junction, CO
National Provider Identifier
1295349785
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC
Doing business as
SCL Health Medical Group - Heart & Vascular Institute - Vascular
Practice address
2643 Patterson Rd Ste 401
Grand Junction, CO 81506-1937
Phone
(970) 298-3884
Fax
(970) 372-0955
NPI assigned
Sep 2, 2020
Last updated
Jun 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
Jon McDaniel
Title
VP Finance Medical Group
Phone
(303) 272-0231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

2643 Patterson Rd Ste 401
Grand Junction, CO 81506-1937

Mailing address

2643 Patterson Rd Ste 401
Grand Junction, CO 81506-1937
Phone (970) 298-3884

Other names 1

  • SCL Health Medical Group - Heart & Vascular Institute - Vascular Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140611000363 CO Part B Supplier - Clinic/Group Practice 3779707856 Receives reassigned benefits from 482 practitioners
47 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO; Rifle, CO; Delta, CO; Cortez, CO

Other NPIs on the same Medicare enrollment 47

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

View all 47

National Provider Directory

National Provider Directory
Part of
Exempla S Bdwy Med CNTR

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

2643 Patterson Rd
Ste 401
Grand Junction, CO 81506
Phone (970) 298-3884

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1295349785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2643 PATTERSON RD STE 401",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815061937",
            "telephone_number": "970-298-3884",
            "fax_number": "970-372-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2643 PATTERSON RD STE 401",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815061937",
            "telephone_number": "970-298-3884",
            "fax_number": "970-372-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERMOUNTAIN FRONT RANGE, INC.",
        "enumeration_date": "2020-09-02",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "VP FINANCE MEDICAL GROUP",
        "authorized_official_telephone_number": "303-272-0231"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCL Health Medical Group - Heart & Vascular Institute - Vascular",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SCL Health Medical Group - Heart & Vascular Institute - Vascular",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.