Individual provider Active NPI

Jerrilu Atkins, M.D.

  • Family Medicine Physician
  • Vail, CO
National Provider Identifier
1811970239
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35763 Issued in CO
Practice address
180 S Frontage Rd W Ste 5800
Vail, CO 81657-5038
Phone
(970) 926-6340
Fax
(970) 926-6348
NPI assigned
Nov 21, 2005
Last updated
Feb 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35763 CO Primary

Addresses

Primary practice location

180 S Frontage Rd W Ste 5800
Vail, CO 81657-5038

Mailing address

PO Box 4330
Avon, CO 81620-4330
Phone (970) 845-2903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100621000336 CO Practitioner - Family Practice 7517097405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Mountain Medical, LLCGroup PAC ID 5496087181, 63 clinicians

Practice addresses (Care Compare)

180 S Frontage Rd W
Suite 5800
Vail, CO 81657-5038
Phone (970) 926-6340

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35763COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Mountain Medical, LLC CurrentSince Aug 17, 2019 Accepting new patients
Colorado Mountain Medical, LLC CurrentSince Aug 17, 2019 Accepting new patients
Colorado Mountain Medical, LLC Family Medicine CurrentSince Sep 8, 2019 Accepting new patients

Locations

377 Sylvan Lake Rd
Eagle, CO 81631
Phone (970) 328-1650

377 Sylvan Lake Rd
Ste 120
Eagle, CO 81631
Phone (970) 926-1800

377 Sylvan Lake Rd
Ste 210
Eagle, CO 81631
Phone (970) 328-1650

322 Beard Creek Rd
Ste 200
Edwards, CO 81632
Phone (970) 328-1650

108 S Frontage Rd W
Ste 101
Vail, CO 81657

180 S Frontage Rd W
Ste 5800
Vail, CO 81657

181 W Meadow Dr
Vail, CO 81657
Phone (970) 479-5157

Interoperability endpoints

  • Direct secure messaging: jerriluatkins@coloradomo.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1811970239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4330",
            "city": "AVON",
            "state": "CO",
            "postal_code": "816204330",
            "telephone_number": "970-845-2903",
            "fax_number": "970-926-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S FRONTAGE RD W STE 5800",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575038",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINS",
        "first_name": "JERRILU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "35763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vail, CO

Sources for this page

Verify at the official NPI Registry.