NPIMap

Organization Active NPI

Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Longmont, CO
National Provider Identifier
1578289518
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
ROCKY MOUNTAIN CLINICS LLC
Practice address
1308 Vivian St
Longmont, CO 80501-3217
Phone
(303) 834-8809
NPI assigned
Oct 12, 2022
Last updated
Mar 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Authorized official

Name
Sabrina Gibson
Title
Cfo
Phone
(970) 493-9193

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

1308 Vivian St
Longmont, CO 80501-3217

Mailing address

1120 E Elizabeth St Ste G2
Fort Collins, CO 80524-4044

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230117001707 CO Part B Supplier - Clinic/Group Practice 5597136218 Receives reassigned benefits from 79 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gunnison, CO; La Junta, CO; Lakewood, CO; Las Animas, CO; Longmont, CO; Loveland, CO; Northglenn, CO; Pueblo, CO…

Other NPIs on the same Medicare enrollment 30

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

View all 30

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2140671Rocky Mountain Clinic - Longmont1308 Vivian St, Longmont, CO 80501Certificate of waiverNov 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Rocky Mountain Clinics LLC43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

Locations

1120 E Elizabeth St
Ste 2
Fort Collins, CO 80524

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1578289518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E ELIZABETH ST STE G2",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 VIVIAN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013217",
            "telephone_number": "303-834-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "970-493-9193"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.