Mt Carmel Primary Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

30427 Issued in CO

Legal business name

MT CARMEL PRIMARY CARE

Practice address

911 Robinson Ave
Trinidad, CO 81082-2811

Phone

(719) 845-4800

Fax

(866) 712-1013

NPI assigned

Jun 9, 2014

Last updated

Apr 10, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Christy Herder

Title

Credentialing Manager

Phone

(303) 386-2727

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1326451105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 ROBINSON AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822811",
            "telephone_number": "719-845-4800",
            "fax_number": "866-712-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 ROBINSON AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822811",
            "telephone_number": "719-845-4800",
            "fax_number": "866-712-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT CARMEL PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-09",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "HERDER",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "303-386-2727",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "30427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81030258",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Damian N Mizera, M.D.
• Monade Counseling, LLC
• Jeanette Monteleone, D.C.
• Amy Johnna Montoya, BSW/MA
• Mountain Family Wellness, LLC
• Mt Rose Health Center
• Mt Rose Health Center Palliative Care and Hospice Inc
• Mt. Carmel Urgent Care - Trinidad, L.L.C.
• Jesse Veris Mullins, PTA
• Leona May Myers

• Primary Care Clinic/Center in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.