Coal Creek Ambulatory Surgery Center PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

CO44716 Issued in CO

Legal business name

COAL CREEK AMBULATORY SURGERY CENTER PC

Practice address

130 Old Laramie TRL BLDG 4
Lafayette, CO 80026

Phone

(303) 664-9400

NPI assigned

Jan 7, 2013

Organization subpart

No

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

Authorized official

Name

Becky Buckley

Title

Billing Manager

Phone

(970) 522-2750

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coal Creek Ambulatory Surgery Center Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Listed as

Coal Creek ASCCCN 06C0001156

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

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

• Glenn Eric Herrmann, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Lafayette, CO
  • NPI 1629085196
  NPD (past)

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1417294745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 767",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "80026",
            "telephone_number": "303-664-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 OLD LARAMIE TRL BLDG 4",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "80026",
            "telephone_number": "303-664-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAL CREEK AMBULATORY SURGERY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "970-522-2750"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CO",
            "license": "CO44716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000150725",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manager@coalcreekplasticsurgery.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "130 Old Laramie Trl Bldg 4",
            "city": "Lafayette",
            "state": "CO",
            "country_code": "US",
            "postal_code": "80026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manager@coalcreekplasticsurgery.com",
            "affiliation": "N",
            "address_1": "130 Old Laramie Trl Bldg 4",
            "city": "Lafayette",
            "state": "CO",
            "country_code": "US",
            "postal_code": "80026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Coal Creek Ambulatory Surgery Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Coal Creek Ambulatory Surgery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Clinica Campesina Family Health Services
• Rikki Clos, LCSW
• Caitlin Clough, LSW
• Kelley Morrison Cluzel, P.T.
• Co Specialty Dental Services, PLLC
• Coal Creek Chiropractic, PLLC
• Coal Creek Meals on Wheels
• Coal Creek Oral Surgery and Dental Implant Center, PLLC
• Coalition for Queer Joy, LLC
• Emma Cohan, PSYD

• Ambulatory Surgical Clinic/Center in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Ambulatory Surgical Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.