Red Mountain Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

RED MOUNTAIN INTERNAL MEDICINE

Practice address

1338 Phay Ave
Canon City, CO 81212-2311

Phone

(719) 219-2400

Fax

(719) 219-2409

NPI assigned

Mar 6, 2021

Organization subpart

No

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

Authorized official

Name

Timothy Michael Bresnahan, MDNPI 1205860202

Title

Authorized Offical

Phone

(720) 261-5141

Specialties & licenses 1

Addresses

Tax ID family

Red Mountain Internal Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Red Mountain Internal Medicine

  • Internal Medicine Physician
  • Delta, CO
  • NPI 1043805583
  NPD tax ID

Practitioners 1

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

• Timothy Michael Bresnahan, MD

  • Internal Medicine Physician
  • Sterling, CO
  • NPI 1205860202
  NPD (past) Authorized official

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

{
    "created_epoch": "1614988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1497340939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 804",
            "city": "MANITOU SPRINGS",
            "state": "CO",
            "postal_code": "808290804",
            "telephone_number": "720-261-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 PHAY AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122311",
            "telephone_number": "719-219-2400",
            "fax_number": "719-219-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED MOUNTAIN INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-06",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "BRESNAHAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICAL",
        "authorized_official_telephone_number": "720-261-5141",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reams Palace Drug Inc
• Rebecca Moore MD
• Recovery Objects Inc.
• Red Canyon Village LLC
• Red Canyon Village LLC
• Red Mountain Radiology Professional LLC
• Daniel Odell Reed, PA
• Regenerative and Wellness Medicine P.C.
• Rehab for All LLC
• Rehab for All LLC

• Internal Medicine Physician in Canon City, CO
• Providers in Canon City, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.