NPIMap

Individual provider Active NPI

Ryan Gillum, MD

  • Family Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1316437833
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0063161 Issued in CO
Practice address
2698 Patterson Rd Ste 100
Grand Junction, CO 81506-8211
Phone
(907) 298-2800
NPI assigned
May 10, 2018
Last updated
May 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DR.0063161 CO Primary
Hospitalist Physician 208M00000X DR.0063161 CO

Addresses

Primary practice location

2698 Patterson Rd Ste 100
Grand Junction, CO 81506-8211

Mailing address

2698 Patterson Road
Grand Junction, CO 81506-8211

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
I20210810002935 CO Practitioner - Family Practice 7113276239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Mark a Norden MD PCGroup PAC ID 0749204022, 5 clinicians
Summit Community Care Clinic IncGroup PAC ID 8022284074, shared by 8 NPIs, 13 clinicians

Practice addresses (Care Compare)

2635 N 7TH St
Suite 4205 Grand Junction Hospitalists
Grand Junction, CO 81501-8209
Phone (970) 298-7783

340 Peak One Dr
Frisco, CO 80443-9900
Phone (303) 885-4673

PO Box
Suite 4337
Frisco, CO 80443

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0063161COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mark a Norden M.D.,PC CurrentSince Jan 1, 2023 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Family Medicine Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Sep 1, 2021 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Sep 1, 2021 Accepting new patients
St Mary's Hospital and Medical Center, Inc Family Medicine Past Accepting new patients
St. Mary's Hospital and Medical Center, Inc. Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

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

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2635 N 7th St
Ste 4205
Grand Junction, CO 81501
Phone (970) 298-7049

2698 Patterson Rd
Grand Junction, CO 81506
Phone (970) 298-2800

2698 Patterson Rd
Ste 100
Grand Junction, CO 81506
Phone (970) 298-2273

Organizations & group practices 7

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 5

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1316437833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 PATTERSON ROAD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 PATTERSON RD STE 100",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068211",
            "telephone_number": "907-298-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLUM",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0063161",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0063161",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.