NPIMap

Organization Active NPI

Community Medical Group, LLC

  • Family Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1629201637
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY MEDICAL GROUP, LLC
Practice address
1060 Orchard Ave
Suite N
Grand Junction, CO 81501-2997
Phone
(970) 256-6345
NPI assigned
Aug 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Christian Thomas
Title
President and Ceo
Phone
(970) 644-3011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1060 Orchard Ave
Suite N
Grand Junction, CO 81501-2997

Mailing address

PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 263-2619

Other practice location 1

731 Iowa Ave
Ste A
Palisade, CO 81526-8661
Phone (970) 644-4060

Other names 2

  • COMMUNITY CARE OF THE GRAND VALLEY Doing business as
  • Community Care of the Grand Valley Palisade Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040310000712 CO Part B Supplier - Clinic/Group Practice 3971491887 Receives reassigned benefits from 103 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO
O20151222000695 CO Part B Supplier - Clinic/Group Practice 1052612785 Receives reassigned benefits from 123 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO; Meeker, CO; Palisade, CO; Rangely, CO; Grand JCT, CO; Fruita, CO; Delta, CO; Clifton, CO

Other NPIs on the same Medicare enrollment 23

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

View all 23

National Provider Directory

National Provider Directory

Locations

551 Kokopelli Blvd
Fruita, CO 81521
Phone (970) 270-2259

688 23 12 Rd Ste 301
Grand JCT, CO 81505

Practitioners & affiliated clinicians

Practitioners 211

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

View all 211

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1629201637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-263-2619",
            "fax_number": "970-263-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 ORCHARD AVE",
            "address_2": "SUITE N",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012997",
            "telephone_number": "970-256-6345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "731 Iowa Ave",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Palisade",
            "state": "CO",
            "postal_code": "815268661",
            "country_code": "US",
            "telephone_number": "970-644-4060",
            "fax_number": "970-644-3940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-25",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "970-644-3011"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY CARE OF THE GRAND VALLEY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Care of the Grand Valley Palisade",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Care of the Grand Valley Palisade",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.