St. Vrain Surgical Assists, LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

519 Issued in CO

Legal business name

ST. VRAIN SURGICAL ASSISTS, LLC

Practice address

77 Baylor Dr
Longmont, CO 80503-2148

Phone

(303) 819-2025

Fax

(720) 494-0995

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Bill J Parker, PA/C

Title

Owner/MGR

Phone

(303) 819-2025

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1316056260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 BAYLOR DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805032148",
            "telephone_number": "303-819-2025",
            "fax_number": "720-494-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BAYLOR DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805032148",
            "telephone_number": "303-819-2025",
            "fax_number": "720-494-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VRAIN SURGICAL ASSISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "BILL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/MGR",
        "authorized_official_telephone_number": "303-819-2025",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA/C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SSC Longmont Operating Company LLC (Applewood Living Center)
• St. Vincent General Hospital District
• St. Vincent General Hospital District
• St. Vrain Endoscopy Center LLC
• St. Vrain OB-GYN Associates, P.C.
• St. Vrain Valley School District Re-1J
• Tricia Staatz, FNP
• Stacy Ruse Counseling PLLC
• Sarah Jean Stafford
• Julian Staiano, LPCC

• Surgical Physician Assistant in Longmont, CO
• Providers in Longmont, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.