Catholic Health Initiatives Colorado
Organization Active NPI Emergency Medicine Physician · Granby, CO
NPI 1902909237 · NPPES record last updated Apr 16, 2010
Key facts
- NPI
- 1902909237
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- CATHOLIC HEALTH INITIATIVES COLORADO
- Practice address
- 480 E Agate
Granby, CO 80446 - Phone
- (970) 887-7400
- Fax
- (970) 887-9305
- NPI assigned
- Sep 5, 2006
- Organization subpart
- No
Authorized official
- Name
- James Robert Harris
- Title
- Ceo Physician Enterprises
- Phone
- (303) 804-8119
Corporate family (same tax ID) 24
Practitioners 2
-
Raluca Cascaval, MD
-
Lee Michael Fonseca, NP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031215000462 | CO | Part B Supplier - Clinic/Group Practice | 8022927342 |
Receives reassigned benefits from 1,310 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- St Thomas More Centura
Locations
480 E Agate Ave
Granby, CO 80446
Phone (970) 887-2179
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes | ||
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X |
Addresses
Primary practice location
480 E Agate
Granby, CO 80446
Mailing address
Dept 1057
Denver, CO 80291-1057
Phone (303) 486-5504
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04009981 | Medicaid | CO |
Other names
- GRANBY MEDICAL CENTER
Other providers in Granby, CO
- Aspen Wind Counseling, LLC
- Ellen C Auchincloss
- Tyler Scott Bowen
- Andrew W Burns
- Catholic Health Initiatives Colorado
- Catholic Health Initiatives Colorado
- Karen K. Charland
- Colorado West Regional Mental Health, Inc.
- Colorado West Regional Mental Health, Inc.
- Colorado West Regional Mental Health, Inc.
All providers in Granby, CO · Emergency Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.