NPIMap

Organization Active NPI

Rocky Mountain Vein Institute Professional LLC

Doing business as American Vein & Vascular

  • Vascular & Interventional Radiology Physician
  • Pueblo, CO
National Provider Identifier
1457685398
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
ROCKY MOUNTAIN VEIN INSTITUTE PROFESSIONAL LLC
Doing business as
American Vein & Vascular
Practice address
115 E Riverwalk Unit 200
Pueblo, CO 81003-3320
Phone
(719) 543-8346
Fax
(719) 545-1829
NPI assigned
Sep 24, 2009
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Dr. Gordon Fabing Gibbs, MDNPI 1417929373
Title
Owner/Provider
Phone
(719) 543-8346

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Vascular & Interventional Radiology Physician 2085R0204X 45004 CO
Vascular & Interventional Radiology Physician 2085R0204X Primary

Addresses

Primary practice location

115 E Riverwalk Unit 200
Pueblo, CO 81003-3320

Mailing address

PO Box 7702
Loveland, CO 80537-0702
Phone (970) 663-2742

Other practice location 1

1313 S St
Bridgeport, NE 69336-2563
Phone (308) 262-1616

Other names 1

  • American Vein & Vascular Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100211000128 CO Part B Supplier - Clinic/Group Practice 8325181431 Receives reassigned benefits from 26 practitioners
12 other NPIs on this enrollment
Practice locations: Thornton, CO; Pueblo, CO; Parker, CO; Lakewood, CO; Johnstown, CO; Fort Collins, CO; Edwards, CO; Colorado Springs, CO…
O20240418003464 NE Part B Supplier - Clinic/Group Practice 8325181431 Receives reassigned benefits from 3 practitioners
Practice locations: Bridgeport, NE

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

109 Latigo Ln
#D
Canon City, CO 81212
Phone (719) 766-8391

805 Eagleridge Blvd
Ste 50
Pueblo, CO 81008
Phone (719) 584-7415

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1457685398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7702",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370702",
            "telephone_number": "970-663-2742",
            "fax_number": "970-342-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E RIVERWALK UNIT 200",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033320",
            "telephone_number": "719-543-8346",
            "fax_number": "719-545-1829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1313 S St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "NE",
            "postal_code": "693362563",
            "country_code": "US",
            "telephone_number": "308-262-1616",
            "fax_number": "719-545-1829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN VEIN INSTITUTE PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-24",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "FABING",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "719-543-8346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CO",
            "license": "45004",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Vein & Vascular",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.