NPIMap

Organization Active NPI

Community Medical Group, LLC

Doing business as Grand Valley Behavioral Health

  • Specialist
  • Grand Junction, CO
National Provider Identifier
1538713136
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COMMUNITY MEDICAL GROUP, LLC
Doing business as
Grand Valley Behavioral Health
Practice address
605 28 1/4 Rd Unit a
Grand Junction, CO 81506-6020
Phone
(970) 242-9026
NPI assigned
Jul 31, 2019
Last updated
Dec 8, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY MEDICAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Authorized official

Name
Christian Thomas
Title
Ceo/President
Phone
(970) 644-3011

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Specialist 174400000X NU Primary

Addresses

Primary practice location

605 28 1/4 Rd Unit a
Grand Junction, CO 81506-6020

Mailing address

PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 263-2619

Other practice location 1

603 28 1/4 Rd
Grand Junction, CO 81506-6019
Phone (970) 263-2617

Other practice location 2

2596 F Rd
Grand Junction, CO 81505-1443
Phone (970) 254-3180

Other practice location 3

2020 N 12th St
Grand Junction, CO 81501-2914
Phone (970) 644-4422

Other practice location 4

2373 G Rd
Grand Junction, CO 81505-1002
Phone (970) 242-0920

Other practice location 5

101 Jurassic Ave Unit B
Fruita, CO 81521-7713
Phone (970) 858-6677

Other practice location 6

2351 G Rd
Grand Junction, CO 81505-9641
Phone (970) 242-0920

Other identifiers 1

IdentifierTypeStateIssuer
9000177899MedicaidCO

Other names 1

  • Grand Valley Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151222000695 CO Part B Supplier - Clinic/Group Practice 1052612785 Receives reassigned benefits from 123 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO; Meeker, CO; Palisade, CO; Rangely, CO; Grand JCT, CO; Fruita, CO; Delta, CO; Clifton, CO

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Community Medical Group LLC28 organizations share this tax ID, including this one
Part of
Community Medical Group LLC

Other organizations with this tax ID 27

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

View all 27

Locations

2478 Patterson Rd
Ste 27
Grand Junction, CO 81505
Phone (970) 644-4300

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1538713136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-263-2619",
            "fax_number": "970-263-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 28 1/4 RD UNIT A",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815066020",
            "telephone_number": "970-242-9026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 28 1/4 Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815066019",
            "country_code": "US",
            "telephone_number": "970-263-2617",
            "fax_number": "970-263-2619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2596 F Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815051443",
            "country_code": "US",
            "telephone_number": "970-254-3180",
            "fax_number": "970-254-3198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 N 12th St",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815012914",
            "country_code": "US",
            "telephone_number": "970-644-4422",
            "fax_number": "970-263-4239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2373 G Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815051002",
            "country_code": "US",
            "telephone_number": "970-242-0920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Jurassic Ave Unit B",
            "address_purpose": "LOCATION",
            "city": "Fruita",
            "state": "CO",
            "postal_code": "815217713",
            "country_code": "US",
            "telephone_number": "970-858-6677",
            "fax_number": "970-858-6679",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2351 G Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815059641",
            "country_code": "US",
            "telephone_number": "970-242-0920",
            "fax_number": "970-257-6251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY MEDICAL GROUP, LLC",
        "enumeration_date": "2019-07-31",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "970-644-3011"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000177899",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Valley Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.