NPIMap

Organization Active NPI

Geriserve P C

  • Medical Physician Assistant
  • Lafayette, CO
National Provider Identifier
1649336967
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
788 Issued in CO
Legal business name
GERISERVE P C
Practice address
103 Sandler Dr
Lafayette, CO 80026-2536
Phone
(303) 919-4503
Fax
(720) 887-4663
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
George Gilmore, PACNPI 1609840966
Title
Executive Director
Phone
(303) 919-4503

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
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X 788 CO Primary

Addresses

Primary practice location

103 Sandler Dr
Lafayette, CO 80026-2536

Mailing address

103 Sandler Dr
Lafayette, CO 80026-2536
Phone (303) 919-4503

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649336967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SANDLER DR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262536",
            "telephone_number": "303-919-4503",
            "fax_number": "720-887-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SANDLER DR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262536",
            "telephone_number": "303-919-4503",
            "fax_number": "720-887-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERISERVE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "303-919-4503",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.