Individual provider Active NPI

Richard A Shand, MD

  • Internal Medicine Physician
  • La Junta, CO
National Provider Identifier
1497804520
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20661 Issued in CO
Practice address
111 W 2ND St
La Junta, CO 81050-1508
Phone
(719) 384-2771
Fax
(719) 384-2077
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20661 CO Primary

Addresses

Primary practice location

111 W 2ND St
La Junta, CO 81050-1508

Mailing address

111 W 2ND St
P.O. Box 496
La Junta, CO 81050-1508
Phone (719) 384-2771

Other identifiers 1

IdentifierTypeStateIssuer
01206614MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080129000082 CO Practitioner - Internal Medicine 7012099104 Reassigns benefits to 1 organization
Practice locations: La Junta, CO

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

111 W 2ND St
La Junta, CO 81050-1508
Phone (719) 384-2771

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20661COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Valley Regional Medical Center Current Accepting new patients

Locations

1100 Carson Ave
La Junta, CO 81050
Phone (719) 383-6000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1497804520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W 2ND ST",
            "address_2": "P.O. BOX 496",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810501508",
            "telephone_number": "719-384-2771",
            "fax_number": "719-384-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W 2ND ST",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810501508",
            "telephone_number": "719-384-2771",
            "fax_number": "719-384-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAND",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "20661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01206614",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Junta, CO

Sources for this page

Verify at the official NPI Registry.