NPIMap

Organization Active NPI

Intermountain Medical Group Grand Junction, LLC

Doing business as SCL Health Medical Group - Maternal Fetal Medicine

  • Obstetrics & Gynecology Physician
  • Grand Junction, CO
National Provider Identifier
1356954598
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC
Doing business as
SCL Health Medical Group - Maternal Fetal Medicine
Practice address
610 25 Rd
Grand Junction, CO 81505-1202
Phone
(970) 298-2275
Fax
(970) 298-7814
NPI assigned
Aug 27, 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
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

610 25 Rd
Grand Junction, CO 81505-1202

Mailing address

610 25 Rd
Grand Junction, CO 81505-1202
Phone (970) 298-2275

Other names 1

  • SCL Health Medical Group - Maternal Fetal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Intermountain Medical Group46 organizations share this tax ID, including this one
Part of
Exempla Diabetes Center

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

Locations

610 25 Rd
Grand Junction, CO 81505
Phone (970) 298-9600

NPI Registry JSON

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

{
    "created_epoch": "1598486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1356954598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 25 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051202",
            "telephone_number": "970-298-2275",
            "fax_number": "970-298-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 25 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051202",
            "telephone_number": "970-298-2275",
            "fax_number": "970-298-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERMOUNTAIN FRONT RANGE, INC.",
        "enumeration_date": "2020-08-27",
        "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": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCL Health Medical Group - Maternal Fetal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SCL Health Medical Group - Maternal Fetal Medicine",
            "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.