Longs Peak Family Practice, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LONGS PEAK FAMILY PRACTICE, PC

Practice address

1309 Sunset St
Longmont, CO 80501-3215

Phone

(303) 772-5578

Fax

(303) 772-8207

NPI assigned

Aug 12, 2006

Last updated

Feb 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Susan I Roach, M.D.NPI 1467454694

Title

Officer

Phone

(303) 772-5578

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 8

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.

• Allison Fostveit, RN, BSN, BS, MSN-FNP

  • Nurse Practitioner
  • Longmont, CO
  • NPI 1487068151

  Family Medicine

  Medicare reassignment Care Compare group NPD
• James Timothy Keeling, M.D.

  • Family Medicine Physician
  • Longmont, CO
  • NPI 1154717676
  Medicare reassignment Care Compare group NPD
• Christopher C Madden, MD

  • Family Medicine Physician
  • Longmont, CO
  • NPI 1689676819
  Medicare reassignment Care Compare group NPD
• Allison Marie Mitas, FNP

  • Family Nurse Practitioner
  • Lafayette, CO
  • NPI 1013220565

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Rebecca Ann Myers, M.D.

  • Family Medicine Physician
  • Longmont, CO
  • NPI 1417116146
  Medicare reassignment Care Compare group NPD
• Eric Traister, M.D.

  • Family Medicine Physician
  • Longmont, CO
  • NPI 1104141670
  Medicare reassignment Care Compare group NPD
• Samantha Jo Steelman, PAC

  • Medical Physician Assistant
  • Longmont, CO
  • NPI 1104151570
  Medicare reassignment Care Compare group
• Susan I Roach, MD

  • Family Medicine Physician
  • Longmont, CO
  • NPI 1467454694
  Authorized official Same address or phone

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1477565380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 SUNSET ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013215",
            "telephone_number": "303-772-5578",
            "fax_number": "303-772-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 SUNSET ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013215",
            "telephone_number": "303-772-5578",
            "fax_number": "303-772-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS PEAK FAMILY PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "303-772-5578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Longmont United Hospital (Longmont United Professional Compensation)
• Longmont United Hospital (the homestead)
• Longmont Vision Center LLC
• Longmont-Mountain View Surgery Center LLC
• Longs Peak Emergency Physicians, PC
• Longs Peak Healthcare, Inc. (McIntosh Care and Rehabilitation Center)
• Longs Peak Healthcare, Inc. (McIntosh Care and Rehabilitation Center)
• Longs Peak Hospital
• Longs Peak Hospital
• Chandra Rae Lontz-Smith, LPC

• Family Medicine Physician in Longmont, CO
• Providers in Longmont, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; 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.