NPIMap

Organization Active NPI

Southwestern Colorado Ear Nose and Throat

  • Otolaryngology Physician
  • Durango, CO
National Provider Identifier
1689607947
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
DR44598 Issued in CO
Legal business name
SOUTHWESTERN COLORADO EAR NOSE AND THROAT
Practice address
1 Mercado St
Suite 205
Durango, CO 81301-7300
Phone
(970) 385-7272
Fax
(970) 385-7299
NPI assigned
Jul 9, 2006
Last updated
Oct 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Authorized official

Name
Dr. Gregory M. Schackel, M.D.NPI 1831148352
Title
President
Phone
(970) 385-7272

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
Otolaryngology Physician 207Y00000X DR44598 CO Primary

Addresses

Primary practice location

1 Mercado St
Suite 205
Durango, CO 81301-7300

Mailing address

1 Mercado St
Suite 205
Durango, CO 81301-7300
Phone (970) 385-7272

Other identifiers 1

IdentifierTypeStateIssuer
93787278MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060816000428 CO Part B Supplier - Clinic/Group Practice 7719980580 Receives reassigned benefits from 7 practitioners
Practice locations: Durango, CO

National Provider Directory

National Provider Directory

Locations

1 Mercado St
Ste 205
Durango, CO 81301
Phone (970) 385-7272

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFBEAA

Practitioners & affiliated clinicians

Practitioners 11

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1689607947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "SUITE 205",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017300",
            "telephone_number": "970-385-7272",
            "fax_number": "970-385-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "SUITE 205",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017300",
            "telephone_number": "970-385-7272",
            "fax_number": "970-385-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN COLORADO EAR NOSE AND THROAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "SCHACKEL",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-385-7272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "DR44598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93787278",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.