Your Family Medical Home,PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

31975 Issued in CO

Legal business name

YOUR FAMILY MEDICAL HOME,PLLC

Practice address

435 N Park Av
Suite 2a
Breckenridge, CO 80424

Phone

(970) 238-7070

Fax

(970) 453-5332

NPI assigned

Mar 10, 2010

Last updated

Aug 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John David Zaitz

Title

Administrator

Phone

(925) 597-0121

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1720301344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5620",
            "city": "BRECKENRIDGE",
            "state": "CO",
            "postal_code": "804245620",
            "telephone_number": "970-238-7070",
            "fax_number": "970-423-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N PARK AV",
            "address_2": "SUITE 2A",
            "city": "BRECKENRIDGE",
            "state": "CO",
            "postal_code": "80424",
            "telephone_number": "970-238-7070",
            "fax_number": "970-453-5332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR FAMILY MEDICAL HOME,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2021-08-17",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "ZAITZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "925-597-0121"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "31975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81751737",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01319755",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Michael Welch, PT, DPT
• Michael Wiadro, L.AC
• Larry Gale Willhite, M.D.
• Alaina Carol Wischmeyer, DC
• Tori Kristine Woodward, DPT
• Michael Yura, RPH
• Deborah Martin Zimmerman, PA

• Family Medicine Physician in Breckenridge, CO
• Providers in Breckenridge, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.