NPIMap

Individual provider Active NPI

Brad Nichol, MD

  • Surgery Physician
  • Glenwood Springs, CO
National Provider Identifier
1912065756
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
CO38600 Issued in CO
Practice address
1830 Blake Ave
#202 Roaring Fork Surgical
Glenwood Springs, CO 81601
Phone
(970) 945-6533
Fax
(970) 945-3945
NPI assigned
Dec 5, 2006
Last updated
May 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X CO38600 CO Primary

Addresses

Primary practice location

1830 Blake Ave
#202 Roaring Fork Surgical
Glenwood Springs, CO 81601

Mailing address

1830 Blake Ave
#202 Roaring Fork Surgical
Glenwood Springs, CO 81601
Phone (970) 945-6533

Other identifiers 1

IdentifierTypeStateIssuer
30886830MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120502000277 CO Practitioner - General Surgery 6709048051 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley View Hospital AssociationGroup PAC ID 1850294778, 205 clinicians

Practice addresses (Care Compare)

1906 Blake Ave
Glenwood SPGS, CO 81601-4227

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)15
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CO38600COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Assoc of the Roaring Fork Current Accepting new patients
Valley View Hospital Association Current Accepting new patients
Valley View Hospital Association CurrentSince Apr 1, 2024 Accepting new patients
Valley View Hospital Association Surgery CurrentSince Apr 1, 2024 Accepting new patients
Valley View Hospital Association Surgery CurrentSince Apr 1, 2024 Accepting new patients
Valley View Hospital Association Current Accepting new patients
Valley View Hospital Association Current Accepting new patients

Locations

1830 Blake Ave
Ste 202
Glenwood Springs, CO 81601
Phone (970) 384-4220

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

Interoperability endpoints

  • Direct secure messaging: brad.nichol.1@9028.direct.athenahealth.com
  • Direct secure messaging: vvh_him@direct.vvh.org

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1912065756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "address_2": "#202 ROARING FORK SURGICAL",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "81601",
            "telephone_number": "970-945-6533",
            "fax_number": "970-945-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "address_2": "#202 ROARING FORK SURGICAL",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "81601",
            "telephone_number": "970-945-6533",
            "fax_number": "970-945-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOL",
        "first_name": "BRAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "CO38600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30886830",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood Springs, CO

Sources for this page

Verify at the official NPI Registry.