NPIMap

Individual provider Active NPI

Gwendolyn Grant, M.D.

  • Rheumatology Physician
  • Durango, CO
National Provider Identifier
1841395357
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
DR.0044790 Issued in CO
Practice address
1010 Three Springs Blvd Ste 275
Durango, CO 81301-8296
Phone
(970) 764-3740
Fax
(970) 764-3643
NPI assigned
Sep 13, 2006
Last updated
Jan 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X DR.0044790 CO Primary

Addresses

Primary practice location

1010 Three Springs Blvd Ste 275
Durango, CO 81301-8296

Mailing address

1010 Three Springs Blvd Ste 275
Durango, CO 81301-8296
Phone (970) 764-3740

Other identifiers 3

IdentifierTypeStateIssuer
85030872MedicaidCO
428822MedicaidAZ
R4911MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061102000025 CO Practitioner - RheumatologyPractitioner - Internal Medicine 5597762633 Reassigns benefits to 1 organization
I20061106000579 TX Practitioner - RheumatologyPractitioner - Internal Medicine 5597762633 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Yale University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians
Southern Colorado Ute Service UnitGroup PAC ID 2163454968, 6 clinicians
Southern Ute Indian TribeGroup PAC ID 6800928292, 13 clinicians

Practice addresses (Care Compare)

1010 Three Springs Blvd
Suite 275
Durango, CO 81301-8296
Phone (970) 764-3740

232 Rustling Willow St
Ute Mountain Ute
Towaoc, CO 81334-0049
Phone (970) 565-4441

232 Rustling Willow St Complex D
Towaoc, CO 81334-0049

PO Box
Ignacio, CO 81137

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.69 of 100Reported as group
Quality
71.4
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Ute Service Unit CurrentSince Apr 22, 2009 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Oct 1, 2005 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Oct 1, 2005 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jul 1, 2013 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jul 1, 2013 Accepting new patients
Spine Colorado PC Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

1010 Three Springs Blvd
#255
Durango, CO 81301
Phone (970) 764-3800

1010 Three Springs Blvd
Ste 275
Durango, CO 81301
Phone (970) 764-3740

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

6 Road 7586
Bloomfield, NM 87413
Phone (505) 368-8015

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16938/brand/1/csg/21/fhir/r4

Organizations & group practices 9

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1841395357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD STE 275",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018296",
            "telephone_number": "970-764-3740",
            "fax_number": "970-764-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD STE 275",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018296",
            "telephone_number": "970-764-3740",
            "fax_number": "970-764-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "GWENDOLYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CO",
            "license": "DR.0044790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85030872",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428822",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R4911",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.