NPIMap

Organization Active NPI

Southwest Emergency Physicians, PC

  • Emergency Medicine Physician
  • Durango, CO
National Provider Identifier
1568495653
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOUTHWEST EMERGENCY PHYSICIANS, PC
Practice address
1010 Three Springs Blvd
Emergency Department
Durango, CO 81301-8296
Phone
(970) 764-2100
NPI assigned
Jul 9, 2006
Last updated
Dec 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Authorized official

Name
Susan Graham, MDNPI 1730193756
Title
President
Phone
(970) 247-4311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1010 Three Springs Blvd
Emergency Department
Durango, CO 81301-8296

Mailing address

PO Box 17752
Denver, CO 80217-0752
Phone (303) 306-7783

Other identifiers 3

IdentifierTypeStateIssuer
46454314MedicaidCO
S0674431OtherBCBS
50178598MedicaidNM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1568495653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17752",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802170752",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018296",
            "telephone_number": "970-764-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST EMERGENCY PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-247-4311",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46454314",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "S0674431",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50178598",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.