NPIMap

Organization Active NPI

Community Medical Group, LLC

Doing business as Grand Valley Infectious Disease

  • Specialist
  • Grand Junction, CO
National Provider Identifier
1922573468
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COMMUNITY MEDICAL GROUP, LLC
Doing business as
Grand Valley Infectious Disease
Practice address
688 23 1/2 Road
Suite 303
Grand Junction, CO 81505-8904
Phone
(970) 644-3820
Fax
(970) 644-3917
NPI assigned
Oct 11, 2018
Last updated
Jan 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
Christian Thomas
Title
President/Ceo
Phone
(970) 242-0920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

688 23 1/2 Road
Suite 303
Grand Junction, CO 81505-8904

Mailing address

PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 644-3820

Other practice location 1

2020 N 12th St
Grand Junction, CO 81501-2914
Phone (970) 644-3820

Other practice location 2

2373 G Rd Ste 160
Grand Jct, CO 81505-1003
Phone (970) 644-3820

Other identifiers 1

IdentifierTypeStateIssuer
9000174788MedicaidCO

Other names 1

  • Grand Valley Infectious Disease Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151222000695 CO Part B Supplier - Clinic/Group Practice 1052612785 Receives reassigned benefits from 123 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO; Meeker, CO; Palisade, CO; Rangely, CO; Grand JCT, CO; Fruita, CO; Delta, CO; Clifton, CO

Other NPIs on the same Medicare enrollment 19

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

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Community Medical Group28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

2503 Foresight Cir
Unit B
Grand Junction, CO 81505
Phone (970) 644-4030

Practitioners & affiliated clinicians

Practitioners 9

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": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1922573468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-644-3820",
            "fax_number": "970-644-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 23 1/2 ROAD",
            "address_2": "SUITE 303",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815058904",
            "telephone_number": "970-644-3820",
            "fax_number": "970-644-3917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 N 12th St",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815012914",
            "country_code": "US",
            "telephone_number": "970-644-3820",
            "fax_number": "970-644-3917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2373 G Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Grand Jct",
            "state": "CO",
            "postal_code": "815051003",
            "country_code": "US",
            "telephone_number": "970-644-3820",
            "fax_number": "970-644-3917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "970-242-0920"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000174788",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Valley Infectious Disease",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.