NPIMap

Organization Active NPI

Gunnison Valley Hospital

Doing business as Gunnison Valley Family Medicine at WCU

  • Student Health Clinic/Center
  • Gunnison, CO
National Provider Identifier
1619502622
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
GUNNISON VALLEY HOSPITAL
Doing business as
Gunnison Valley Family Medicine at WCU
Practice address
104 Tomichi Hall Western Colorado University
Gunnison, CO 81231-1920
Phone
(970) 943-2707
NPI assigned
Mar 10, 2020
Last updated
Apr 18, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GUNNISON VALLEY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Mark Vanderveer
Title
Cfo
Phone
(970) 642-4760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X NU Primary

Addresses

Primary practice location

104 Tomichi Hall Western Colorado University
Gunnison, CO 81231-1920

Mailing address

711 N Taylor St
Gunnison, CO 81230-2208
Phone (970) 943-2707

Other names 1

  • Gunnison Valley Family Medicine at WCU Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331000463 CO Part B Supplier - Clinic/Group Practice 8426040486 Receives reassigned benefits from 181 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gunnison, CO; Telluride, CO; Crested Butte, CO

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2064376Gunnison Valley Health Family Medicine104 Tomichi Hall, Western State College, CO 81231Certificate of waiverAug 18, 2027

National Provider Directory

National Provider Directory
Part of
Gunnison County Hospita

Locations

104 E Tomichi Ave
Gunnison, CO 81230
Phone (970) 943-2484

Practitioners & affiliated clinicians

Practitioners 3

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": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1619502622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N TAYLOR ST",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812302208",
            "telephone_number": "970-943-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 TOMICHI HALL WESTERN COLORADO UNIVERSITY",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812311920",
            "telephone_number": "970-943-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNNISON VALLEY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNNISON VALLEY HOSPITAL",
        "enumeration_date": "2020-03-10",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "VANDERVEER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "970-642-4760"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gunnison Valley Family Medicine at WCU",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gunnison, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.