NPIMap

Organization Active NPI

Breckenridge Medical Clinic, LLC

  • Emergency Medicine Physician
  • Breckenridge, CO
National Provider Identifier
1376682740
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
BRECKENRIDGE MEDICAL CLINIC, LLC
Doing business as
Breckenridge Medical Clinic, LLC
Practice address
555 South Park Avenue
Plaza 2
Breckenridge, CO 80424
Phone
(970) 453-1010
NPI assigned
Feb 5, 2007
Last updated
Oct 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Authorized official

Name
Mr. Paul Chodowski
Title
President/Ceo
Phone
(970) 668-2852

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

555 South Park Avenue
Plaza 2
Breckenridge, CO 80424

Mailing address

Department 1965
Denver, CO 80291-1965
Phone (303) 486-5500

Other names 1

  • Breckenridge Medical Clinic, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

Dept 1965
Denver, CO 80291

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1376682740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT 1965",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802911965",
            "telephone_number": "303-486-5500",
            "fax_number": "303-486-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SOUTH PARK AVENUE",
            "address_2": "PLAZA 2",
            "city": "BRECKENRIDGE",
            "state": "CO",
            "postal_code": "80424",
            "telephone_number": "970-453-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRECKENRIDGE MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "CHODOWSKI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "970-668-2852",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breckenridge Medical Clinic, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Breckenridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.