NPIMap

Organization Active NPI

Boulder Community Health

  • Medical Specialty Clinic/Center
  • Erie, CO
National Provider Identifier
1457907263
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
BOULDER COMMUNITY HEALTH
Practice address
101 Erie Pkwy Ste 201a
Erie, CO 80516-4072
Phone
(303) 442-2395
Fax
(303) 442-1073
NPI assigned
Aug 16, 2019
Organization subpart
Yes
Parent organization
BOULDER COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Authorized official

Name
William A Munson Jr.
Title
VP,Cfo
Phone
(303) 415-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

101 Erie Pkwy Ste 201a
Erie, CO 80516-4072

Mailing address

PO Box 9049
Boulder, CO 80301-9049
Phone (303) 442-2395

Other names 2

  • Community Medical Assoc of B.C.H. Doing business as
  • Boulder Heart Erie Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000284 CO Part B Supplier - Clinic/Group Practice 6800707233 Receives reassigned benefits from 316 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Erie, CO; Superior, CO; Longmont, CO; Lafayette, CO; Boulder, CO

National Provider Directory

National Provider Directory
Tax ID family
Michael Vongortler MD82 organizations share this tax ID, including this one
Part of
Michael Vongortler MD

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

101 Erie Pkwy
Ste 201A
Erie, CO 80516

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1457907263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9049",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803019049",
            "telephone_number": "303-442-2395",
            "fax_number": "303-442-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ERIE PKWY STE 201A",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805164072",
            "telephone_number": "303-442-2395",
            "fax_number": "303-442-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOULDER COMMUNITY HEALTH",
        "enumeration_date": "2019-08-16",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP,CFO",
        "authorized_official_telephone_number": "303-415-8800",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Medical Assoc of B.C.H.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Medical Assoc of B.C.H.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boulder Heart Erie",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Erie, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.