Colorado Mountain Medical, LLC
Organization Active NPI Multi-Specialty Clinic/Center · Edwards, CO
NPI 1356930622 · NPPES record last updated Jun 8, 2022
Key facts
- NPI
- 1356930622
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- COLORADO MOUNTAIN MEDICAL, LLC
- Practice address
- 320 Beard Creek Rd Ste 100
Edwards, CO 81632-6433 - Phone
- (970) 476-8872
- NPI assigned
- Jan 12, 2021
- Organization subpart
- No
Authorized official
- Name
- Diane Voytko
- Title
- Physician President
- Phone
- (970) 926-6340
Other NPIs on the same Medicare enrollment 26
Corporate family (same tax ID) 27
Practitioners 3
-
Rebecca Adochio, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191030000595 | CO | Part B Supplier - Clinic/Group Practice | 5496087181 |
Receives reassigned benefits from 70 practitioners 26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Vail, CO; Glenwood Spring, CO; Frisco, CO; Edwards, CO; Eagle, CO; Avon, CO; Dillon, CO |
National Provider Directory
- Tax ID family
- Colorado Mountain Medical LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
320 Beard Creek Rd Ste 100
Edwards, CO 81632-6433
Mailing address
PO Box 4330
Avon, CO 81620-4330
Phone (970) 926-6340
Other providers in Edwards, CO
- David James Cimino
- Cle Physical Therapy, PLLC
- Luke Cobb
- Colorado Mountain College
- Colorado Mountain Medical, LLC
- Colorado Mountain Medical, LLC
- Colorado Mountain Medical, LLC
- Colorado Mountain Medical, LLC
- Colorado Occupational Therapy
- Carol Susan Conger
All providers in Edwards, CO · Multi-Specialty Clinic/Center in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.