Boulder Community Health
Organization Active NPI Medical Specialty Clinic/Center · Superior, CO
NPI 1508413196 · NPPES record last updated Jun 29, 2022
Key facts
- NPI
- 1508413196
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Specialty Clinic/Center 261QM2500X
- Legal business name
- BOULDER COMMUNITY HEALTH
- Practice address
- 3 Superior Dr Ste 100C
Superior, CO 80027-8653 - Phone
- (303) 415-4344
- Fax
- (303) 425-9259
- NPI assigned
- Aug 20, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- BOULDER COMMUNITY HEALTH
Authorized official
- Name
- William A Munson Jr.
- Title
- VP,Cfo
- Phone
- (303) 415-7433
Corporate family (same tax ID) 24
Practitioners 7
-
Sofia Mani Davies, DO, MS
-
Sarah Elizabeth Kramer, PT, DPT
-
Melissa Ann Kushlak, D.O.
-
Kelly Morgenstein, PAC
-
Natalie Julie Morshead, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040123000284 | CO | Part B Supplier - Clinic/Group Practice | 6800707233 |
Receives reassigned benefits from 316 practitioners This NPI is an additional NPI on the enrollment Practice locations: Erie, CO; Superior, CO; Longmont, CO; Lafayette, CO; Boulder, CO |
National Provider Directory
- Tax ID family
- Michael Vongortler MD
- Part of
- Michael Vongortler MD
Locations
2101 Ken Pratt Blvd
Ste 104A
Longmont, CO 80501
Phone (303) 415-4155
3 Superior Dr
Ste 100C
Superior, CO 80027
Phone (303) 415-4344
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | Yes |
Addresses
Primary practice location
3 Superior Dr Ste 100C
Superior, CO 80027-8653
Mailing address
PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-4344
Other names
- Community Medical Assoc of B.C.H.
- Endocrinology Associates of B.C.H. (NWFM)
Other providers in Superior, CO
- Pamela Bloom
- Cynthia L Bogacki
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Strength PT, LLC
All providers in Superior, CO · Medical Specialty Clinic/Center in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2022. 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.