Rocky Mountain Clinics LLC
Organization Active NPI Addiction Medicine (Family Medicine) Physician · Walsenburg, CO
NPI 1710695499 · NPPES record last updated Mar 14, 2023
Key facts
- NPI
- 1710695499
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Addiction Medicine (Family Medicine) Physician 207QA0401X
- Legal business name
- ROCKY MOUNTAIN CLINICS LLC
- Practice address
- 928 Russell Ave
Walsenburg, CO 81089-2155 - Phone
- (866) 628-7828
- NPI assigned
- Nov 10, 2022
- Organization subpart
- No
Authorized official
- Name
- Sabrina Gibson
- Title
- Cfo
- Phone
- (970) 493-9193
Other NPIs on the same Medicare enrollment 30
Corporate family (same tax ID) 42
Practitioners 55
-
Robert Scott Dill, PA-C
-
Jacquelyn Shawn Adams, LCSW
-
Allison Jean Ahern, NP-C
-
Alexandra Anderson, PA-C
-
Karen Bant-Kreutzer, ANP-C
-
Tonia Bershinsky, FNP-C
-
Stephen Carleton, LCSW, CAS
-
Eleanor Marie Davis, APRN
-
Kenneth John Davis, PA-C
-
Karissa Caylene Gayosso, AGACNP-BC
-
Samantha Gehring, FNP-C
-
Radene Lynn Hamlett, PN0334444
-
Joshua Hammond, MD
-
Claudia R. Imes, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230117001707 | CO | Part B Supplier - Clinic/Group Practice | 5597136218 |
Receives reassigned benefits from 79 practitioners 30 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Gunnison, CO; La Junta, CO; Lakewood, CO; Las Animas, CO; Longmont, CO; Loveland, CO; Northglenn, CO; Pueblo, CO… |
National Provider Directory
- Tax ID family
- Rocky Mountain Clinics LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Addiction Medicine (Family Medicine) Physician |
207QA0401X | Yes |
Addresses
Primary practice location
928 Russell Ave
Walsenburg, CO 81089-2155
Mailing address
1120 E Elizabeth St Ste G2
Fort Collins, CO 80524-4044
Other providers in Walsenburg, CO
- Poudre Valley Medical Group, LLC
- Pueblo Community Health Center Inc
- Pueblo Community Health Center Inc
- Pueblo Radiological Group, P.C.
- Qualicenters Pueblo, LLC
- Sangre de Cristo Community Care
- Barbara Jean Sargent
- Seventh Day Assisted Living
- Shoff Smiles, PC
- James Shoff
All providers in Walsenburg, CO · Addiction Medicine (Family Medicine) Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.