Individual provider Active NPI

John Steve Lavengood, M.D.

  • Family Medicine Physician
  • Durango, CO
National Provider Identifier
1619020435
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28293 Issued in CO
Practice address
1970 E 3Rd Ave # Until1
Durango, CO 81301-5056
Phone
(970) 335-2288
Fax
(970) 335-2280
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28293 CO Primary

Addresses

Primary practice location

1970 E 3Rd Ave # Until1
Durango, CO 81301-5056

Mailing address

PO Box 1328
Durango, CO 81302-1328
Phone (970) 335-2314

Other practice location 1

52 Village Dr
Pagosa Springs, CO 81147-8368
Phone (970) 264-2104

Other practice location 2

495 W 4th St
Dove Creek, CO 81324-4900
Phone (970) 335-2288

Other practice location 3

691 E Empire St
Cortez, CO 81321-2802
Phone (970) 565-7946

Other identifiers 1

IdentifierTypeStateIssuer
01282938MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040107000960 CO Practitioner - Family Practice 0446157366

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28293COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Colorado Mental Health Center, Inc Current Accepting new patients
Valley-Wide Health Systems, Inc. Past Accepting new patients

Locations

691 E Empire St
Cortez, CO 81321
Phone (970) 335-2232

495 W 4th St
Dove Creek, CO 81324
Phone (970) 677-2291

1970 E 3rd Ave
Ste 1
Durango, CO 81301
Phone (970) 335-2288

52 Village Dr
Pagosa Springs, CO 81147
Phone (970) 264-2104

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1619020435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1328",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813021328",
            "telephone_number": "970-335-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 E 3RD AVE # UNTIL1",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015056",
            "telephone_number": "970-335-2288",
            "fax_number": "970-335-2280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 Village Dr",
            "address_purpose": "LOCATION",
            "city": "Pagosa Springs",
            "state": "CO",
            "postal_code": "811478368",
            "country_code": "US",
            "telephone_number": "970-264-2104",
            "fax_number": "970-264-2108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "495 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Dove Creek",
            "state": "CO",
            "postal_code": "813244900",
            "country_code": "US",
            "telephone_number": "970-335-2288",
            "fax_number": "970-335-2280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "691 E Empire St",
            "address_purpose": "LOCATION",
            "city": "Cortez",
            "state": "CO",
            "postal_code": "813212802",
            "country_code": "US",
            "telephone_number": "970-565-7946",
            "fax_number": "970-565-9005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVENGOOD",
        "first_name": "JOHN",
        "middle_name": "STEVE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "28293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01282938",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.