Rocky Mountain Sports Medicine Inc.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

ROCKY MOUNTAIN SPORTS MEDICINE INC.

Practice address

12760 Stroh Ranch Way Ste 202
Parker, CO 80134-7507

Phone

(720) 851-5420

Fax

(720) 851-5801

NPI assigned

Aug 12, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Kathryn Vidlock Granley, M.D.

Title

Owner/Physician

Phone

(720) 592-0112

Specialties & licenses 1

Addresses

Electronic endpoints 2

Locations

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1588210934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12760 STROH RANCH WAY STE 202",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347507",
            "telephone_number": "720-592-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12760 STROH RANCH WAY STE 202",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347507",
            "telephone_number": "720-851-5420",
            "fax_number": "720-851-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN SPORTS MEDICINE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "VIDLOCK GRANLEY",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "720-592-0112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Parker",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12760 Stroh Ranch Way Ste 202",
            "city": "Parker",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801347507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Parker",
            "affiliation": "N",
            "endpointDescription": "clinic",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12760 Stroh Ranch Way Ste 202",
            "city": "Parker",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801347507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rocky Mountain Health Diagnostics LLC
• Rocky Mountain Pain Specialists
• Rocky Mountain Pain Specialists
• Rocky Mountain Pathology Consultants, PC
• Rocky Mountain Physicians Group, PC
• Rocky Mountain Vein Institute PLLC
• Mary Ann Rodgers, CMI
• Rodolph Company LLC
• Gregory J Rodolph
• Amanda Eileen Rodriguez, RD

• Sports Medicine (Family Medicine) Physician in Parker, CO
• Providers in Parker, CO by specialty
• Sports Medicine (Family Medicine) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.