327 Medical Prof Corp
Organization Active NPI General Practice Physician · Salida, CO
NPI 1396957114 · NPPES record last updated Mar 24, 2020
Key facts
- NPI
- 1396957114
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 208D00000X (CO)
- Legal business name
- 327 MEDICAL PROF CORP
- Practice address
- 910 Rush Dr
Salida, CO 81201-9665 - Phone
- (719) 539-6637
- Fax
- (719) 539-5275
- NPI assigned
- May 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Joel Evans Schaler, MD
- Title
- President
- Phone
- (719) 539-6637
Practitioners 8
-
Matthew David Burkley, M.D.
-
Sarah Laing, FNP-C
-
Daniel Lombardo, M.D.
-
Joel Schaler, MD
-
Jennifer E Lee, P.A.
-
Jamie Vollmerhausen, P.A.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040311001139 | CO | Part B Supplier - Clinic/Group Practice | 4587553227 |
Receives reassigned benefits from 7 practitioners Practice locations: Salida, CO |
National Provider Directory
Locations
327 E 1st St
Salida, CO 81201
Phone (719) 539-6637
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | 208D00000X | CO | Yes |
Addresses
Primary practice location
910 Rush Dr
Salida, CO 81201-9665
Mailing address
910 Rush Dr
Salida, CO 81201-9665
Phone (719) 539-6637
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04006110 | Medicaid | CO |
Other providers in Salida, CO
All providers in Salida, CO · General Practice Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.