NPIMap

Organization Active NPI

Blue Creek Medicine PC

Doing business as Blue Creek Family Medicine

  • Family Medicine Physician
  • Evergreen, CO
National Provider Identifier
1598701591
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BLUE CREEK MEDICINE PC
Doing business as
Blue Creek Family Medicine
Practice address
1520 Evergreen Pkwy
Evergreen, CO 80439-7848
Phone
(303) 674-2273
NPI assigned
Jun 20, 2006
Last updated
Dec 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Authorized official

Name
Kit K Brekhus, MDNPI 1003866880
Title
President
Phone
(303) 674-2273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1520 Evergreen Pkwy
Evergreen, CO 80439-7848

Mailing address

PO Box 1926
Evergreen, CO 80437-1926
Phone (303) 674-2273

Other identifiers 3

IdentifierTypeStateIssuer
BL661575OtherCOBLUE SHIELD
CK5669OtherCORR MEDICARE
45959234MedicaidCO

Other names 1

  • Blue Creek Family Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

3464 S Willow St
#357
Denver, CO 80231

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1598701591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1926",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804371926",
            "telephone_number": "303-674-2273",
            "fax_number": "303-670-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 EVERGREEN PKWY",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397848",
            "telephone_number": "303-674-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE CREEK MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "BREKHUS",
        "authorized_official_first_name": "KIT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-674-2273",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "BL661575",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CK5669",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45959234",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Creek Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evergreen, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.