NPIMap

Individual provider Active NPI

Joshua William Kanik, MD

  • Family Medicine Physician
  • Rifle, CO
National Provider Identifier
1598051534
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0065169 Issued in CO
Practice address
501 Airport Rd FL 2
Rifle, CO 81650
Phone
(970) 625-1100
Fax
(970) 625-2752
NPI assigned
Jun 28, 2011
Last updated
Oct 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41287 IA
Family Medicine Physician 207Q00000X DR.0065169 CO Primary

Addresses

Primary practice location

501 Airport Rd FL 2
Rifle, CO 81650

Mailing address

501 Airport Rd FL 2
Rifle, CO 81650-8510
Phone (970) 625-1100

Other practice location 1

407 S White St
Henry County Health Center
Mt Pleasant, IA 52641
Phone (319) 385-6153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200923001486 CO Practitioner - Family Practice 0941436000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand River Hospital DistrictGroup PAC ID 7113837469, shared by 5 NPIs, 79 clinicians

Practice addresses (Care Compare)

201 Sipprelle Dr
Parachute, CO 81635-9234
Phone (970) 625-6462

501 Airport Rd
Rifle, CO 81650-8510
Phone (970) 625-6462

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0065169COMDFamily Medicine Physician
41287IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand River Hospital District CurrentSince Nov 2, 2020 Accepting new patients
Grand River Hospital District CurrentSince Nov 2, 2020 Accepting new patients
Grand River Hospital District CurrentSince Sep 4, 2025 Accepting new patients

Locations

501 Airport Rd
Rifle, CO 81650
Phone (970) 625-1100

501 Airport Rd
Fl 2
Rifle, CO 81650
Phone (970) 625-1100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1598051534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 AIRPORT RD FL 2",
            "city": "RIFLE",
            "state": "CO",
            "postal_code": "816508510",
            "telephone_number": "970-625-1100",
            "fax_number": "970-625-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 AIRPORT RD FL 2",
            "city": "RIFLE",
            "state": "CO",
            "postal_code": "81650",
            "telephone_number": "970-625-1100",
            "fax_number": "970-625-2752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "407 S White St",
            "address_2": "Henry County Health Center",
            "address_purpose": "LOCATION",
            "city": "Mt Pleasant",
            "state": "IA",
            "postal_code": "52641",
            "country_code": "US",
            "telephone_number": "319-385-6153",
            "fax_number": "319-272-2107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANIK",
        "first_name": "JOSHUA",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "41287",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0065169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rifle, CO

Sources for this page

Verify at the official NPI Registry.