NPIMap

Organization Active NPI

St Mary's Hospital and Medical Center, Inc

Doing business as Intermountain Health Bloomin' Babies - Telluride Satellite

  • Obstetrics & Gynecology Physician
  • Telluride, CO
National Provider Identifier
1902563877
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ST MARY'S HOSPITAL AND MEDICAL CENTER, INC
Doing business as
Intermountain Health Bloomin' Babies - Telluride Satellite
Practice address
500 W Pacific Ave
Telluride, CO 81435
Phone
(970) 549-1711
Fax
(970) 314-2633
NPI assigned
Nov 26, 2021
Last updated
Jan 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Authorized official

Name
Terri L Chinn
Title
VP Finance
Phone
(970) 298-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

500 W Pacific Ave
Telluride, CO 81435

Mailing address

500 Eldorado Blvd Ste 6300
Broomfield, CO 80021-3422
Phone (303) 272-0566

Other names 1

  • Intermountain Health Bloomin' Babies - Telluride Satellite Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000149 CO Part B Supplier - Clinic/Group Practice 1557267069 Receives reassigned benefits from 137 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
Sisters of Charity of Leavenworth Health System Inc

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1637884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1902563877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ELDORADO BLVD STE 6300",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213422",
            "telephone_number": "303-272-0566",
            "fax_number": "303-272-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W PACIFIC AVE",
            "city": "TELLURIDE",
            "state": "CO",
            "postal_code": "81435",
            "telephone_number": "970-549-1711",
            "fax_number": "970-314-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY'S HOSPITAL AND MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC",
        "enumeration_date": "2021-11-26",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "CHINN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "970-298-2020"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Bloomin' Babies - Telluride Satellite",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Telluride, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.