Boulder Community Health
Organization Active NPI Primary Care Clinic/Center · Boulder, CO
NPI 1942856745 · NPPES record last updated Jul 5, 2022
Key facts
- NPI
- 1942856745
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- BOULDER COMMUNITY HEALTH
- Practice address
- 2575 Spruce St
Boulder, CO 80302-3806 - Phone
- (303) 415-3875
- Fax
- (303) 449-3112
- NPI assigned
- Aug 16, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- BOULDER COMMUNITY HEALTH
Authorized official
- Name
- William A Munson Jr.
- Title
- VP, Cfo
- Phone
- (303) 415-7433
Corporate family (same tax ID) 17
Practitioners 4
-
Rachel Natalya Cooke, PA-C
-
Paula Marica Pook, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040123000284 | CO | Part B Supplier - Clinic/Group Practice | 6800707233 |
Receives reassigned benefits from 316 practitioners This NPI is an additional NPI on the enrollment Practice locations: Erie, CO; Superior, CO; Longmont, CO; Lafayette, CO; Boulder, CO |
National Provider Directory
- Tax ID family
- Michael Vongortler MD
- Part of
- Michael Vongortler MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
2575 Spruce St
Boulder, CO 80302-3806
Mailing address
PO Box 9049
Boulder, CO 80301-9049
Phone (303) 415-3875
Other names
- Community Medical Assoc of BCH
- Spruce Street Internal Medicine
Other providers in Boulder, CO
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health
- Boulder Community Health Sports Medicine Imaging LLC
- Boulder Community Hospital
All providers in Boulder, CO · Primary Care Clinic/Center in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2022. 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.