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Rocky Mountain Clinics, LLC

Organization Active NPI Addiction Medicine (Family Medicine) Physician · Arvada, CO

NPI 1386478642 · NPPES record last updated Aug 29, 2024

Key facts

NPI
1386478642
Entity type
Organization (NPI type 2)
Primary specialty
Addiction Medicine (Family Medicine) Physician 207QA0401X
Legal business name
ROCKY MOUNTAIN CLINICS, LLC
Practice address
8725 Wadsworth Blvd Ste C
Arvada, CO 80003-0922
Phone
(970) 493-9193
NPI assigned
Aug 29, 2024
Organization subpart
No

Authorized official

Name
Sabrina Gibson
Title
Cfo
Phone
(307) 277-1006

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

Corporate family (same tax ID) 42

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

View all 42

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 56

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2310233Rocky Mountain Clinic - Arvada
8725 Wadsworth Blvd, Suite C, Arvada, CO 80003		Certificate of waiverAug 28, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230117001707 CO Part B Supplier - Clinic/Group Practice 5597136218 Receives reassigned benefits from 79 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gunnison, CO; La Junta, CO; Lakewood, CO; Las Animas, CO; Longmont, CO; Loveland, CO; Northglenn, CO; Pueblo, CO…

National Provider Directory

Tax ID family
Rocky Mountain Clinics LLC (43 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Addiction Medicine (Family Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207QA0401X Yes

Addresses

Primary practice location

8725 Wadsworth Blvd Ste C
Arvada, CO 80003-0922

Mailing address

1120 E Elizabeth St Ste G2
Fort Collins, CO 80524-4044
Phone (970) 443-8268

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 29, 2024.

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1386478642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E ELIZABETH ST STE G2",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244044",
            "telephone_number": "970-443-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 WADSWORTH BLVD STE C",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800030922",
            "telephone_number": "970-493-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN CLINICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-277-1006"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

All providers in Arvada, CO · Addiction Medicine (Family Medicine) Physician in Colorado

Sources for this page

Verify at the official NPI Registry.