NPIMap

Organization Active NPI

Total Life Care, LLC

  • Family Medicine Physician
  • Colorado City, CO
National Provider Identifier
1679516348
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TOTAL LIFE CARE, LLC
Practice address
4491 Bent Bros. Blvd
Colorado City, CO 81019
Phone
(719) 676-2273
Fax
(719) 676-3297
NPI assigned
Jun 13, 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
Grady King Snyder Jr., M.D.
Title
Owner/Provider
Phone
(719) 676-2273

Specialties & licenses 1

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

Addresses

Primary practice location

4491 Bent Bros. Blvd
Colorado City, CO 81019

Mailing address

PO Box 19873
Colorado City, CO 81019-0873
Phone (719) 676-2273

Other identifiers 1

IdentifierTypeStateIssuer
59422548MedicaidCO

National Provider Directory

National Provider Directory

Locations

4005 Jerry Murphy Rd
Pueblo, CO 81001
Phone (719) 543-9158

Practitioners & affiliated clinicians

Practitioners 9

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": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679516348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19873",
            "city": "COLORADO CITY",
            "state": "CO",
            "postal_code": "810190873",
            "telephone_number": "719-676-2273",
            "fax_number": "719-676-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 BENT BROS. BLVD",
            "city": "COLORADO CITY",
            "state": "CO",
            "postal_code": "81019",
            "telephone_number": "719-676-2273",
            "fax_number": "719-676-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL LIFE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "GRADY",
        "authorized_official_middle_name": "KING",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "719-676-2273",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59422548",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado City, 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.