The Pagosa Medical Group LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

THE PAGOSA MEDICAL GROUP LLC

Practice address

215 E 12TH St
Durango, CO 81301-5206

Phone

(970) 372-0456

NPI assigned

Aug 16, 2022

Organization subpart

Yes

Parent organization

THE PAGOSA MEDICAL GROUP LLCAs reported in NPPES

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

Authorized official

Name

Rhonda L Ash

Title

Practice Administrator

Phone

(970) 372-0456

Specialties & licenses 1

Addresses

Other names 1

• Pagosa Medical Group Durango Other name

Part of

The Pagosa Medical Group LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• The Pagosa Medical Group LLC

  • Surgery Physician
  • Pagosa SPGS, CO
  • NPI 1255857660
  NPPES parent name

Practitioners 1

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

• Heidi S. McMillan, MD

  • Pediatrics Physician
  • Durango, CO
  • NPI 1457371742
  NPD

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1497473391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27B TALISMAN DR UNIT 3",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811477914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 12TH ST",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015206",
            "telephone_number": "970-372-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PAGOSA MEDICAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE PAGOSA MEDICAL GROUP LLC",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "ASH",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "970-372-0456"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pagosa Medical Group Durango",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yohanes Fisehaye Tesfay
• Amy E Testa, MSPT
• Michael T Testa, MSPT
• Regan S Thaw, LCSW
• The Community Firm Dba the Community Economic (CEDP-Durango)
• The Training Room
• Ann Theine, PA-C
• Therapeutic Experiences, LLC
• Therapy Collective LLC
• Therapy for Rebels PLLC (Neurodiversity-Affirming Psychotherapy Training Institute)

• Pediatrics Physician in Durango, CO
• Providers in Durango, CO by specialty
• Pediatrics Physician in Colorado

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