NPIMap

Individual provider Active NPI

Caitlin Luke

  • Physician Assistant
  • Fruita, CO
National Provider Identifier
1932833688
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0008858 Issued in CO
Practice address
401 Kokopelli Blvd Ste 1
Fruita, CO 81521-3308
Phone
(970) 858-9894
NPI assigned
Jul 10, 2022
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0008858 CO Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

401 Kokopelli Blvd Ste 1
Fruita, CO 81521-3308

Mailing address

PO Box 130
Fruita, CO 81521-0130
Phone (970) 858-2186

Other practice location 1

2763 Compass Dr Apt 304
Grand Junction, CO 81506-3929
Phone (970) 778-9642

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
I20241104003355 CO Practitioner - Physician Assistant 2860925427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 130
Fruita, CO 81521

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Valley Hospital Association CurrentSince Nov 17, 2024 Accepting new patients
Lower Valley Hospital Association CurrentSince Nov 17, 2024 Accepting new patients
Lower Valley Hospital Association Past Accepting new patients
Lower Valley Hospital Association Past Accepting new patients
Lower Valley Hospital Association Past Accepting new patients

Locations

300 W Ottley Ave
#W
Fruita, CO 81521

401 Kokopelli Blvd
Ste 1
Fruita, CO 81521
Phone (970) 858-2705

401 Kokopelli Blvd
Ste 3
Fruita, CO 81521
Phone (970) 200-1510

2237 Redlands Pkwy
Grand Junction, CO 81507
Phone (970) 858-9894

Organizations & group practices 5

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 6

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": "1657411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1932833688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815210130",
            "telephone_number": "970-858-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KOKOPELLI BLVD STE 1",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815213308",
            "telephone_number": "970-858-9894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2763 Compass Dr Apt 304",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815063929",
            "country_code": "US",
            "telephone_number": "970-778-9642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUKE",
        "first_name": "CAITLIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-10",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008858",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruita, CO

Sources for this page

Verify at the official NPI Registry.