NPIMap

Organization Active NPI

Bender Medical Group

Doing business as Miramont Family Medicine

  • Family Medicine Physician
  • Fairplay, CO
National Provider Identifier
1952743510
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BENDER MEDICAL GROUP
Doing business as
Miramont Family Medicine
Practice address
525 Hathaway St
Fairplay, CO 80440-0760
Phone
(719) 836-1900
Fax
(719) 836-3283
NPI assigned
Jul 24, 2013
Last updated
Jul 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Authorized official

Name
Julie M Desaire
Title
Director
Phone
(970) 225-5107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

525 Hathaway St
Fairplay, CO 80440-0760

Mailing address

525 Hathaway
Fairplay, CO 80440-0760
Phone (719) 836-1900

Other names 1

  • Miramont Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bender Medical Group Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1952743510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 HATHAWAY",
            "city": "FAIRPLAY",
            "state": "CO",
            "postal_code": "804400760",
            "telephone_number": "719-836-1900",
            "fax_number": "719-836-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 HATHAWAY ST",
            "city": "FAIRPLAY",
            "state": "CO",
            "postal_code": "804400760",
            "telephone_number": "719-836-1900",
            "fax_number": "719-836-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENDER MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "DESAIRE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "970-225-5107"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miramont Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairplay, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.