NPIMap

Organization Active NPI

Boulder Family Practice Clinic

  • Family Medicine Physician
  • Boulder, CO
National Provider Identifier
1811976186
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18572 Issued in CO
Legal business name
BOULDER FAMILY PRACTICE CLINIC
Practice address
1000 Alpine Ave
#220
Boulder, CO 80304-3406
Phone
(303) 996-6804
Fax
(303) 996-6807
NPI assigned
Jan 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Dr. Philip Frederick Weber, M.D.NPI 1285613646
Title
President
Phone
(303) 996-6804

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 18572 CO Primary

Addresses

Primary practice location

1000 Alpine Ave
#220
Boulder, CO 80304-3406

Mailing address

1000 Alpine Ave
#220
Boulder, CO 80304-3406
Phone (303) 996-6804

Other identifiers 1

IdentifierTypeStateIssuer
56530544MedicaidCO

National Provider Directory

National Provider Directory

Locations

1000 Alpine Ave
Ste 181
Boulder, CO 80304
Phone (303) 449-5774

1000 Alpine Ave
Ste 220
Boulder, CO 80304
Phone (303) 996-6804

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1811976186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ALPINE AVE",
            "address_2": "#220",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043406",
            "telephone_number": "303-996-6804",
            "fax_number": "303-996-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ALPINE AVE",
            "address_2": "#220",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043406",
            "telephone_number": "303-996-6804",
            "fax_number": "303-996-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER FAMILY PRACTICE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-996-6804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "18572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56530544",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.