Organization Active NPI

Vincent T Yu MD PC

  • Surgery Physician
  • Canon City, CO
National Provider Identifier
1497865240
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
30832 Issued in CO
Legal business name
VINCENT T YU MD PC
Practice address
1121 Main St
Canon City, CO 81212-3413
Phone
(719) 276-2116
Fax
(719) 276-6919
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Authorized official

Name
Mr. Vincent T. Yu, M.D.
Title
Owner
Phone
(719) 276-2116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 30832 CO Primary

Addresses

Primary practice location

1121 Main St
Canon City, CO 81212-3413

Mailing address

P.O. Box 1614
Canon City, CO 81212-1614
Phone (719) 276-2116

Other identifiers 1

IdentifierTypeStateIssuer
04017075MedicaidCO

National Provider Directory

National Provider Directory

Locations

1145 Ohio Ave
Ste A
Canon City, CO 81212
Phone (719) 275-4061

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1497865240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1614",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812121614",
            "telephone_number": "719-276-2116",
            "fax_number": "719-276-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 MAIN ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123413",
            "telephone_number": "719-276-2116",
            "fax_number": "719-276-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT T YU MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "YU",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-276-2116",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CO",
            "license": "30832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04017075",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.