Organization Active NPI

Colorado Institute for Neuromuscular and Neurological Disorders, PLLC

  • Neurology Physician
  • Longmont, CO
National Provider Identifier
1790847705
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
41261 Issued in CO
Legal business name
COLORADO INSTITUTE FOR NEUROMUSCULAR AND NEUROLOGICAL DISORDERS, PLLC
Practice address
600 S Airport Rd
Suite E, BLDG. B
Longmont, CO 80503-6424
Phone
(720) 491-3322
Fax
(720) 684-6715
NPI assigned
Dec 15, 2006
Last updated
Jan 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Dr. Pierre V Pavot, D.O.NPI 1285631440
Title
Owner
Phone
(303) 485-3535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 41261 CO Primary

Addresses

Primary practice location

600 S Airport Rd
Suite E, BLDG. B
Longmont, CO 80503-6424

Mailing address

600 S Airport Rd
Suite E, BLDG. B
Longmont, CO 80503-6424
Phone (720) 491-3322

Other identifiers 1

IdentifierTypeStateIssuer
02306719MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051031000629 CO Part B Supplier - Clinic/Group Practice 8224055058 Receives reassigned benefits from 1 practitioner
Practice locations: Longmont, CO

National Provider Directory

National Provider Directory

Locations

2030 Mountain View Ave
Ste 220
Longmont, CO 80501
Phone (303) 702-5995

600 S Airport Rd
Bldg B
Longmont, CO 80503
Phone (720) 491-3402

600 S Airport Rd
Ste E
Longmont, CO 80503
Phone (303) 772-1700

Practitioners & affiliated clinicians

Practitioners 2

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1790847705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S AIRPORT RD",
            "address_2": "SUITE E, BLDG. B",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036424",
            "telephone_number": "720-491-3322",
            "fax_number": "720-684-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S AIRPORT RD",
            "address_2": "SUITE E, BLDG. B",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036424",
            "telephone_number": "720-491-3322",
            "fax_number": "720-684-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO INSTITUTE FOR NEUROMUSCULAR AND NEUROLOGICAL DISORDERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "PAVOT",
        "authorized_official_first_name": "PIERRE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-485-3535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "41261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02306719",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 13, 2015; 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.