Active NPI
Peak Medical Colorado No. 2, LLC
- Skilled Nursing Facility
- Grand Junction, CO
National Provider Identifier
1720038854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0478
- Legal business name
- PEAK MEDICAL COLORADO NO. 2, LLC
- Doing business as
- Mesa Manor Center
- Practice address
- 2901 N 12TH St
Grand Junction, CO 81506-2811 - Phone
- (970) 243-7211
- Fax
- (970) 245-5104
- NPI assigned
- May 11, 2006
- Organization subpart
- Yes
- Parent organization
- SUNBRIDGE HEALTHCARE LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael T Berg
- Title
- Assistant Secretary
- Phone
- (505) 821-3355
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0478 | CO | Primary |
Addresses
Primary practice location
2901 N 12TH St
Grand Junction, CO 81506-2811
Mailing address
101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26837081 | Medicaid | CO | |
| 46279865 | Medicaid | CO |
Other names 1
- Mesa Manor Center
National Provider Directory
National Provider Directory- Part of
- Terrace Hghts Nursing H
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1640044800000",
"number": "1720038854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SUN AVE NE",
"address_2": "COMPLIANCE DEPARTMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094373",
"telephone_number": "505-468-5604",
"fax_number": "505-468-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 N 12TH ST",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815062811",
"telephone_number": "970-243-7211",
"fax_number": "970-245-5104"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEAK MEDICAL COLORADO NO. 2, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE LLC",
"enumeration_date": "2006-05-11",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A",
"authorized_official_last_name": "BERG",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "ASSISTANT SECRETARY",
"authorized_official_telephone_number": "505-821-3355"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CO",
"license": "0478",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "26837081",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "46279865",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mesa Manor Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Mesa Manor Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Grand Junction, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.