Organization Active NPI

Surgical Associates of Western Colorado, P.C.

  • Surgery Physician
  • Grand Junction, CO
National Provider Identifier
1811917669
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGICAL ASSOCIATES OF WESTERN COLORADO, P.C.
Practice address
1060 Orchard Ave
Suite I
Grand Junction, CO 81501-2997
Phone
(970) 243-9340
Fax
(970) 241-6894
NPI assigned
Jul 21, 2006
Last updated
Apr 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Authorized official

Name
Debbie D Johns
Title
Practice Administrator
Phone
(970) 254-1686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1060 Orchard Ave
Suite I
Grand Junction, CO 81501-2997

Mailing address

1060 Orchard Ave
Suite I
Grand Junction, CO 81501-2997
Phone (970) 243-9340

Other identifiers 2

IdentifierTypeStateIssuer
SUU7808OtherCOANTHEM BCBS GROUP#
04009023MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071017000809 CO Part B Supplier - Clinic/Group Practice 0042306300 Receives reassigned benefits from 3 practitioners
Practice locations: Grand Junction, CO

National Provider Directory

National Provider Directory

Locations

2373 G Rd
Ste 280
Grand Junction, CO 81505
Phone (970) 243-9343

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6865/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207872000000",
    "number": "1811917669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 ORCHARD AVE",
            "address_2": "SUITE I",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012997",
            "telephone_number": "970-243-9340",
            "fax_number": "970-241-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 ORCHARD AVE",
            "address_2": "SUITE I",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012997",
            "telephone_number": "970-243-9340",
            "fax_number": "970-241-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES OF WESTERN COLORADO, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-04-11",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "970-254-1686"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS GROUP#",
            "identifier": "SUU7808",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04009023",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.