NPIMap

Organization Active NPI

Pathology Assoc of the Roaring Fork

  • Anatomic Pathology & Clinical Pathology Physician
  • Glenwood SPGS, CO
National Provider Identifier
1386624203
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PATHOLOGY ASSOC OF THE ROARING FORK
Practice address
1906 Blake Ave
Glenwood SPGS, CO 81601-4227
Phone
(970) 945-6535
NPI assigned
Jan 18, 2006
Last updated
Oct 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
Jerry S Steinbrecher, MDNPI 1497735898
Title
President Pathologist
Phone
(970) 945-6535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Primary

Addresses

Primary practice location

1906 Blake Ave
Glenwood SPGS, CO 81601-4227

Mailing address

PO Box 2725
Glenwood SPGS, CO 81602-2725
Phone (970) 945-1443

Other identifiers 2

IdentifierTypeStateIssuer
04020681MedicaidCO
PA636752OtherBLUE CROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 168

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 168

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1386624203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2725",
            "city": "GLENWOOD SPGS",
            "state": "CO",
            "postal_code": "816022725",
            "telephone_number": "970-945-1443",
            "fax_number": "970-947-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BLAKE AVE",
            "city": "GLENWOOD SPGS",
            "state": "CO",
            "postal_code": "816014227",
            "telephone_number": "970-945-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY ASSOC OF THE ROARING FORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-18",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "STEINBRECHER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT PATHOLOGIST",
        "authorized_official_telephone_number": "970-945-6535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04020681",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PA636752",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood SPGS, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.