NPIMap

Organization Active NPI

Community Medical Group, LLC

Doing business as Grand Valley Pediatrics

  • Pediatrics Physician
  • Grand Junction, CO
National Provider Identifier
1730505702
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
COMMUNITY MEDICAL GROUP, LLC
Doing business as
Grand Valley Pediatrics
Practice address
601 28 1/4 Rd Unit B
Grand Junction, CO 81506-6022
Phone
(970) 263-2604
NPI assigned
Mar 13, 2014
Last updated
Apr 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Authorized official

Name
Christian Thomas
Title
President/Ceo
Phone
(970) 256-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

601 28 1/4 Rd Unit B
Grand Junction, CO 81506-6022

Mailing address

PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 263-2604

Other names 1

  • Grand Valley Pediatrics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151222000695 CO Part B Supplier - Clinic/Group Practice 1052612785 Receives reassigned benefits from 123 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO; Meeker, CO; Palisade, CO; Rangely, CO; Grand JCT, CO; Fruita, CO; Delta, CO; Clifton, CO

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2160577Grand Valley Pediatrics601 28 1/4 Road, Grand Junction, CO 81506Certificate of waiverJan 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Community Medical Group LLC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Practitioners & affiliated clinicians

Practitioners 9

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": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1730505702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-263-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 28 1/4 RD UNIT B",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815066022",
            "telephone_number": "970-263-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-13",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "970-256-6200"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Valley Pediatrics",
            "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 Apr 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.