Organization Active NPI

Robert David McCurry DO

Doing business as Canon Family Medicine

  • Family Medicine Physician
  • Canon City, CO
National Provider Identifier
1790971141
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32118 Issued in CO
Legal business name
ROBERT DAVID MCCURRY DO
Doing business as
Canon Family Medicine
Practice address
1210 Main St
Canon City, CO 81212-3506
Phone
(719) 275-3000
Fax
(719) 275-6939
NPI assigned
Sep 19, 2007
Last updated
Jul 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Authorized official

Name
Mr. Robert David McCurry, D.O.NPI 1285634121
Title
Owner/Physician
Phone
(719) 275-3000

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
Family Medicine Physician 207Q00000X 32118 CO Primary

Addresses

Primary practice location

1210 Main St
Canon City, CO 81212-3506

Mailing address

1210 Main St
Canon City, CO 81212-3506
Phone (719) 275-3000

Other identifiers 1

IdentifierTypeStateIssuer
01321181MedicaidCO

Other names 1

  • CANON FAMILY MEDICINE Doing business as

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
06D0873277Canon Family Medicine1210 Main St, Canon City, CO 81212Provider-performed microscopyJul 20, 2027

National Provider Directory

National Provider Directory

Locations

1210 Main St
Canon City, CO 81212
Phone (719) 275-3000

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": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1790971141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 MAIN ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123506",
            "telephone_number": "719-275-3000",
            "fax_number": "719-275-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 MAIN ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123506",
            "telephone_number": "719-275-3000",
            "fax_number": "719-275-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT DAVID MCCURRY DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "MCCURRY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "719-275-3000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "32118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01321181",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CANON FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.