NPIMap

Organization Active NPI

Compassionate Concierge Physicians, LLC

  • Internal Medicine Physician
  • Longmont, CO
National Provider Identifier
1851074140
Registry record updated Aug 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMPASSIONATE CONCIERGE PHYSICIANS, LLC
Practice address
1551 Professional LN Unit 180
Longmont, CO 80501-6970
Phone
(720) 986-0850
NPI assigned
Aug 11, 2023
Last updated
Aug 12, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
COMPASSIONATE CONCIERGE PHYSICIANS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2023

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

Authorized official

Name
Kirk Ernest MitchellNPI 1811149685
Title
President
Phone
(303) 859-9722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X NU
Internal Medicine Physician 207R00000X NU Primary
Physical Medicine & Rehabilitation Physician 208100000X NU
Physician Assistant 363A00000X NU

Addresses

Primary practice location

1551 Professional LN Unit 180
Longmont, CO 80501-6970

Mailing address

5390 Saint Vrain Rd
Longmont, CO 80503-8764
Phone (303) 859-9722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230928002666 WY Part B Supplier - Clinic/Group Practice 4284069378 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Casper, WY; Cheyenne, WY; Lander, WY; Laramie, WY; Sheridan, WY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Compassionate Concierge Physicians LLC

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691798400000",
    "number": "1851074140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5390 SAINT VRAIN RD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805038764",
            "telephone_number": "303-859-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LN UNIT 180",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016970",
            "telephone_number": "720-986-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE CONCIERGE PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMPASSIONATE CONCIERGE PHYSICIANS, LLC",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-08-12",
        "certification_date": "2023-08-12",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "ERNEST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-859-9722"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2023; 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.