NPIMap

Organization Active NPI

Four Corners Heart Clinic

  • Cardiovascular Disease Physician
  • Durango, CO
National Provider Identifier
1942260377
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
FOUR CORNERS HEART CLINIC
Practice address
1800 E 3Rd Ave
Suite112
Durango, CO 81301-5016
Phone
(970) 247-1120
Fax
(970) 247-1128
NPI assigned
Mar 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ann Lau
Title
Director of Accounts Receivable
Phone
(303) 295-8737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

1800 E 3Rd Ave
Suite112
Durango, CO 81301-5016

Mailing address

1800 E 3Rd Ave
Suite 112
Durango, CO 81301-5016
Phone (970) 247-1120

Other identifiers 1

IdentifierTypeStateIssuer
04023420MedicaidCO

National Provider Directory

National Provider Directory

Locations

111 E Railroad Ave
Mancos, CO 81328
Phone (970) 533-9125

Practitioners & affiliated clinicians

Practitioners 10

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": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942260377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E 3RD AVE",
            "address_2": "SUITE 112",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015016",
            "telephone_number": "970-247-1120",
            "fax_number": "970-247-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E 3RD AVE",
            "address_2": "SUITE112",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015016",
            "telephone_number": "970-247-1120",
            "fax_number": "970-247-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS HEART CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "303-295-8737"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04023420",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.