Active NPI
Maida L. Burrow M.D.
- Procedural Dermatology Physician
- Grand Junction, CO
National Provider Identifier
1386888428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Procedural Dermatology Physician
- License
- 26621
- Legal business name
- MAIDA L. BURROW M.D.
- Practice address
- 790 Wellington Ave Ste 103
Grand Junction, CO 81501-6127 - Phone
- (970) 242-0060
- Fax
- (970) 242-6604
- NPI assigned
- Apr 20, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Maida Louise Burrow, M.D.
- Title
- Owner
- Phone
- (970) 242-0060
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | 26621 | CO | Primary |
Addresses
Primary practice location
790 Wellington Ave Ste 103
Grand Junction, CO 81501-6127
Mailing address
790 Wellington Ave Ste 103
Grand Junction, CO 81501-6127
Phone (970) 242-0060
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29274 | Other | CO | BCBS |
| 26621 | Medicaid | CO |
National Provider Directory
National Provider DirectoryLocations
790 Wellington Ave
Ste 103
Grand Junction, CO 81501
Phone (970) 242-0060
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Specialist
- Grand JCT, CO
- NPI 1073602439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240185600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1240185600000",
"number": "1386888428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 WELLINGTON AVE STE 103",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815016127",
"telephone_number": "970-242-0060",
"fax_number": "970-242-6604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 WELLINGTON AVE STE 103",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815016127",
"telephone_number": "970-242-0060",
"fax_number": "970-242-6604"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAIDA L. BURROW M.D.",
"organizational_subpart": "NO",
"enumeration_date": "2009-04-20",
"last_updated": "2009-04-20",
"status": "A",
"authorized_official_last_name": "BURROW",
"authorized_official_first_name": "MAIDA",
"authorized_official_middle_name": "LOUISE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "970-242-0060",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology, Procedural Dermatology",
"state": "CO",
"license": "26621",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "29274",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "26621",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}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 Apr 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.