NPIMap

Organization Active NPI

Telluride Medical Center

  • Emergency Care Clinic/Center
  • Telluride, CO
National Provider Identifier
1508807694
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
0393 Issued in CO
Legal business name
TELLURIDE MEDICAL CENTER
Practice address
500 W Pacific Ave
Telluride, CO 81435
Phone
(970) 369-2311
Fax
(970) 728-3404
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Authorized official

Name
Pam McCreedy
Title
Billing Manager
Phone
(970) 369-2311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X 0393 CO Primary

Addresses

Primary practice location

500 W Pacific Ave
Telluride, CO 81435

Mailing address

PO Box 1229
Telluride, CO 81435-1229
Phone (970) 369-2311

Other identifiers 1

IdentifierTypeStateIssuer
04121042MedicaidCO

Other names 1

  • Telluride Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040413000816 CO Part B Supplier - Clinic/Group Practice 2961496807 Receives reassigned benefits from 8 practitioners
Practice locations: Telluride, CO
O20100930098258 CO DME Supplier - Physician - Family PracticeDME Supplier - Oxygen & Equipment 2961496807 Practice locations: Telluride, CO

National Provider Directory

National Provider Directory
Tax ID family
Telluride Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1508807694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1229",
            "city": "TELLURIDE",
            "state": "CO",
            "postal_code": "814351229",
            "telephone_number": "970-369-2311",
            "fax_number": "970-728-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W PACIFIC AVE",
            "city": "TELLURIDE",
            "state": "CO",
            "postal_code": "81435",
            "telephone_number": "970-369-2311",
            "fax_number": "970-728-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELLURIDE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "MCCREEDY",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "970-369-2311"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "CO",
            "license": "0393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04121042",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Telluride Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Telluride Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Telluride, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.