Sangre de Cristo Family Practice Assoc., P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

27050 Issued in CO

Legal business name

SANGRE DE CRISTO FAMILY PRACTICE ASSOC., P.C.

Practice address

712 Macon Ave
Canon City, CO 81212-3314

Phone

(719) 275-8646

Fax

(888) 484-0223

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Wayne Banker, M.D.NPI 1699848648

Title

President

Phone

(719) 275-8646

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Michael Wayne Banker, M.D.

  • Family Medicine Physician
  • Canon City, CO
  • NPI 1699848648
  Authorized official Same address or phone

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1962536326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 MACON AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123314",
            "telephone_number": "719-275-8646",
            "fax_number": "888-484-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 MACON AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123314",
            "telephone_number": "719-275-8646",
            "fax_number": "888-484-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANGRE DE CRISTO FAMILY PRACTICE ASSOC., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "BANKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-275-8646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "27050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04119046",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven L Samsel, BS
• Haley Marie Sanders, RDH
• Dean E Sandoval, D.D.S.
• Erika R Sandstedt
• Sangre de Cristo Community Care Canon City
• Sangre de Cristo Hospice & Palliative Care (Sangre de Cristo Community Care)
• Claudia J Santee, R.N.
• Darran Dee Sawyer, CRNA
• Shirley Ann Sawyer, NP
• Valerie Schauer, FNP-C

• Primary Care Clinic/Center in Canon City, CO
• Providers in Canon City, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.