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
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, MD
Title
President Pathologist
Phone
(970) 945-6535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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
PA636752OtherBLUE CROSS
04020681MedicaidCO

National Provider Directory

National Provider Directory

Locations

501 Airport Rd
Rifle, CO 81650
Phone (970) 625-1100

Practitioners & affiliated clinicians

Practitioners 167

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

View all 167

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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PA636752",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04020681",
            "state": "CO"
        }
    ],
    "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.