Active NPI
Mary H Gerodetti, MD
- Anesthesiology Physician
- Montrose, CO
National Provider Identifier
1740238237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 30792
- Practice address
- 800 S 3Rd St
Montrose, CO 81401-4212 - Phone
- (970) 249-2211
- NPI assigned
- May 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 30792 | CO | Primary |
Addresses
Primary practice location
800 S 3Rd St
Montrose, CO 81401-4212
Mailing address
PO Box 668
Arvada, CO 80001-0668
Phone (303) 422-9438
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01307925 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30792 | CO | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193961600000",
"number": "1740238237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 668",
"city": "ARVADA",
"state": "CO",
"postal_code": "800010668",
"telephone_number": "303-422-9438",
"fax_number": "303-422-9474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S 3RD ST",
"city": "MONTROSE",
"state": "CO",
"postal_code": "814014212",
"telephone_number": "970-249-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERODETTI",
"first_name": "MARY",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2007-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CO",
"license": "30792",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01307925",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montrose, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.