Individual provider Active NPI

Mary Beth Deering, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Grand Junction, CO
National Provider Identifier
1659362549
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
63617 Issued in CO
Practice address
627 25 1/2 Rd
Grand Junction, CO 81505-6401
Phone
(970) 242-3535
Fax
(970) 623-8599
NPI assigned
Oct 31, 2005
Last updated
May 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X 63617 CO Primary

Addresses

Primary practice location

627 25 1/2 Rd
Grand Junction, CO 81505-6401

Mailing address

627 25 1/2 Rd
Grand Junction, CO 81505-6401
Phone (970) 242-3535

Other identifiers 2

IdentifierTypeStateIssuer
83131540MedicaidCO
P00322762OtherCORAILROAD MEDICARE

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
I20050914001332 CO Practitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 9739157363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Pediatric Medicine
Education
East Tennessee State University Quillen College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

627 25
Grand Junction, CO 81505-6401
Phone (970) 242-3535

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63617COMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC Orthopaedic Surgery CurrentSince Sep 4, 2018 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Sep 4, 2018 Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1659362549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 25 1/2 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815056401",
            "telephone_number": "970-242-3535",
            "fax_number": "970-623-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 25 1/2 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815056401",
            "telephone_number": "970-242-3535",
            "fax_number": "970-623-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEERING",
        "first_name": "MARY BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "CO",
            "license": "63617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83131540",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00322762",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.