Longmont Clinic Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

10251530000 Issued in CO

Legal business name

LONGMONT CLINIC LAB

Practice address

1925 Mountain View Ave
Longmont, CO 80501-3128

Phone

(303) 776-1234

Fax

(720) 494-3107

NPI assigned

Sep 15, 2006

Organization subpart

Yes

Parent organization

LONGMONT CLINIC PCAs reported in NPPES

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

Authorized official

Name

Jack Campbell

Title

Administrator

Phone

(303) 776-1234

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Part of

Longmont Clinic PC Lab

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Longmont Clinic PC

  • General Practice Physician
  • Longmont, CO
  • NPI 1043269772
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marie Bush, MD

  • Internal Medicine Physician
  • Longmont, CO
  • NPI 1467456889
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1619073947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013128",
            "telephone_number": "303-776-1234",
            "fax_number": "720-494-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013128",
            "telephone_number": "303-776-1234",
            "fax_number": "720-494-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGMONT CLINIC LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LONGMONT CLINIC PC",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "303-776-1234"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CO",
            "license": "10251530000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Londono, PA-C
• Timothy J Long
• Gail Suzanne Longenecker, DIP LCM
• Longmont Anesthesia Associates, PLLC
• Longmont Braces
• Longmont Clinic PC
• Longmont Complete Dentistry
• Longmont Dental Care
• Longmont Dental Partners, LLC. (Comfort Dental Longmont)
• Longmont Eyecare, PLLC

• Clinical Medical Laboratory in Longmont, CO
• Providers in Longmont, CO by specialty
• Clinical Medical Laboratory in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.