Family Medicine Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

27053 Issued in CO

Legal business name

FAMILY MEDICINE CLINIC

Practice address

100 W 4TH St
Walsenburg, CO 81089-1910

Phone

(719) 738-1164

Fax

(719) 738-3399

NPI assigned

Aug 23, 2007

Organization subpart

No

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

Authorized official

Name

C David Neece, D.O.

Title

Owner/Provider

Phone

(719) 738-1164

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Surinder P. Brar, P.T.

  • Physical Therapist
  • Aliso Viejo, CA
  • NPI 1255367785
  NPD

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1760675698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W 4TH ST",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810891910",
            "telephone_number": "719-738-1164",
            "fax_number": "719-738-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 4TH ST",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810891910",
            "telephone_number": "719-738-1164",
            "fax_number": "719-738-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "NEECE",
        "authorized_official_first_name": "C DAVID",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "719-738-1164",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CO",
            "license": "27053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C444298",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dolce Management, Inc
• Sherry Dolce
• Marilyn Doster
• Donald Wayne Dutton Jr., M.D.
• Eagleridge Dental
• Thomas Faulhaber, M.D.
• Leah Ferrendelli, RN
• Anna K Fisher, REGISTERED DIETITIAN
• Dale Gillan Jr., MD
• Regina Jo Griego, FNP, ACNP

• General Practice Physician in Walsenburg, CO
• Providers in Walsenburg, CO by specialty
• General Practice Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.