Byers Peak Family Medicine
Organization Active NPI Family Medicine Physician · Winter Park, CO
NPI 1487833539 · NPPES record last updated Jul 9, 2013
Key facts
- NPI
- 1487833539
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BYERS PEAK FAMILY MEDICINE
- Practice address
- 77878 US Highway 40
Suite 6
Winter Park, CO 80482-1312 - Phone
- (970) 722-0300
- NPI assigned
- Oct 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. James Gray Kennedy, MD
- Title
- Physician/Manager
- Phone
- (970) 722-0300
Practitioners 1
-
Kelley K Glancey, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050819000735 | CO | Part B Supplier - Clinic/Group Practice | 0446280325 |
Receives reassigned benefits from 1 practitioner Practice locations: Winter Park, CO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
77878 US Highway 40
Suite 6
Winter Park, CO 80482-1312
Mailing address
PO Box 1312
Winter Park, CO 80482-1312
Phone (970) 722-0300
Other providers in Winter Park, CO
- Alpine Sun Family Medicine
- Michael Bateman
- Carly Pollack Therapy P.C.
- Catholic Health Initiatives Colorado
- Mark N Chua
- Rita Aline Coonrod
- Corona Pass Dental PLLC
All providers in Winter Park, CO · Family Medicine 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 Jul 9, 2013. 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.