NPIMap

Organization Active NPI

Catholic Health Initiatives Colorado

Doing business as PRLS PC SW Longmont

  • Family Medicine Physician
  • Longmont, CO
National Provider Identifier
1780047902
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CATHOLIC HEALTH INITIATIVES COLORADO
Doing business as
PRLS PC SW Longmont
Practice address
2101 Ken Pratt Blvd Ste 200
Longmont, CO 80501-6568
Phone
(303) 649-6350
Fax
(303) 649-3501
NPI assigned
Apr 4, 2016
Last updated
Jun 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Authorized official

Name
Mrs. Angela Jo Skinner
Title
Administrator Oma
Phone
(720) 667-7283

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

2101 Ken Pratt Blvd Ste 200
Longmont, CO 80501-6568

Mailing address

PO Box 800022
Kansas City, MO 64180-0022
Phone (800) 953-0104

Other names 2

  • PRLS PC SW LONGMONT Doing business as
  • CMG Primary Care Southwest. Longmont Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000462 CO Part B Supplier - Clinic/Group Practice 8022927342 Receives reassigned benefits from 1,310 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
St Mary-Corwin Hospital319 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

729 E Spaulding Ave
Pueblo West, CO 81007
Phone (719) 285-2760

Practitioners & affiliated clinicians

Practitioners 3

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": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1780047902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800022",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641800022",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 KEN PRATT BLVD STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016568",
            "telephone_number": "303-649-6350",
            "fax_number": "303-649-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC HEALTH INITIATIVES COLORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-04",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR OMA",
        "authorized_official_telephone_number": "720-667-7283",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRLS PC SW LONGMONT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CMG Primary Care Southwest. Longmont",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.