Monument Sport & Spine LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MONUMENT SPORT & SPINE LLC

Practice address

609 North Ave Ste 1
Grand Junction, CO 81501-7520

Phone

(970) 242-7700

Fax

(970) 242-7711

NPI assigned

Sep 15, 2022

Last updated

Feb 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Evan Bumgarner, DCNPI 1932762929

Title

Owner

Phone

(970) 210-5933

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 2

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.

• Evan R. Bumgarner, DC

  • Chiropractor
  • Grand Junction, CO
  • NPI 1932762929
  Medicare reassignment NPD Authorized official
• Benjamin Wayne Dorenkamp, D.C.

  • Chiropractor
  • Grand Junction, CO
  • NPI 1164519765
  NPD (past)

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1942922000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 NORTH AVE STE 1",
            "city": "GRAND JCT",
            "state": "CO",
            "postal_code": "815017520",
            "telephone_number": "970-242-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 NORTH AVE STE 1",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815017520",
            "telephone_number": "970-242-7700",
            "fax_number": "970-242-7711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "992 25 Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815059667",
            "country_code": "US",
            "telephone_number": "970-210-5933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MONUMENT SPORT & SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "BUMGARNER",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-210-5933",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932762929",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FULCRUM",
            "identifier": "006D0914G",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14426279",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "093574",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Monument Women's Healthcare, LLC (Monument Women's Healthcare)
• Monumental Health and Wellness LLC (Empowered Solutions Psychiatry)
• Monumental Views Optical, LLC
• Alice Rose Moore, MSW, PHD
• Anna Elisabeth Moore, DPM

• Chiropractor in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.