NPIMap

Organization Active NPI

Rocky Mountain Rehab Medicine LLC

  • Physical Medicine & Rehabilitation Physician
  • Longmont, CO
National Provider Identifier
1891240032
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
DR0054748 Issued in CO
Legal business name
ROCKY MOUNTAIN REHAB MEDICINE LLC
Practice address
275 S Main St
Longmont, CO 80501-6462
Phone
(720) 378-6597
NPI assigned
Aug 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Authorized official

Name
Richard Michael Gordon, M.D.
Title
Owner
Phone
(720) 378-6597

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X DR0054748 CO Primary

Addresses

Primary practice location

275 S Main St
Longmont, CO 80501-6462

Mailing address

19153 East Briarwood Drive
Centennial, CO 80016
Phone (843) 324-2406

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1891240032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19153 EAST BRIARWOOD DRIVE",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80016",
            "telephone_number": "843-324-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 S MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016462",
            "telephone_number": "720-378-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN REHAB MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-378-6597",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "DR0054748",
            "primary": true
        }
    ],
    "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 Dec 30, 2019; 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.