Silverton and San Juan Co Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SILVERTON AND SAN JUAN CO CLINIC

Practice address

1315 Snowden Street
Silverton, CO 81433

Phone

(970) 387-5114

Fax

(970) 387-5036

NPI assigned

Jun 24, 2020

Last updated

Jun 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Theresa Brokering, RN

Title

Board Member

Phone

(970) 618-3913

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Silverton Clinic Other name

Electronic endpoints 1

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1811513880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 964",
            "city": "SILVERTON",
            "state": "CO",
            "postal_code": "814330964",
            "telephone_number": "970-387-5114",
            "fax_number": "970-387-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 SNOWDEN STREET",
            "city": "SILVERTON",
            "state": "CO",
            "postal_code": "81433",
            "telephone_number": "970-387-5114",
            "fax_number": "970-387-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERTON AND SAN JUAN CO CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "BROKERING",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "970-618-3913",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREE CLINIC  NO INSURANCE BILLING",
            "identifier": "12345",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "SilvertonClinic",
            "affiliation": "N",
            "endpointDescription": "Paper chart system",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "faxed records,  we are a paper chart system",
            "address_1": "1315 Snowden Street",
            "city": "Silverton",
            "state": "CO",
            "country_code": "US",
            "postal_code": "81433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Silverton Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Miners Family Dental, LLC
• Mountain Goat Therapy
• Jeff Rome, PT, DPT
• Robert Ansley Roof IV, MA LPC
• San Juan County (San Juan County Public Health)
• Silverton San Juan County Ambulance Association Inc.
• Karen M Srebacic
• Anthony Suruda, M.D.
• Taylor G Wright PC

• Primary Care Clinic/Center in Silverton, CO
• Providers in Silverton, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.