NPIMap

Organization Active NPI

Eagle Ridge Operating Company, LLC

Doing business as Eagle Ridge at Grand Valley

  • Skilled Nursing Facility
  • Grand Junction, CO
National Provider Identifier
1982331013
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EAGLE RIDGE OPERATING COMPANY, LLC
Doing business as
Eagle Ridge at Grand Valley
Practice address
2425 Teller Ave
Grand Junction, CO 81501-5107
Phone
(970) 243-3381
Fax
(970) 243-3416
NPI assigned
Aug 8, 2022
Last updated
Aug 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Authorized official

Name
Mary Koretke
Title
Director of Reimbursement
Phone
(720) 974-6278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

2425 Teller Ave
Grand Junction, CO 81501-5107

Mailing address

2425 Teller Ave
Grand Junction, CO 81501-5107
Phone (970) 243-3381

Other names 1

  • Eagle Ridge at Grand Valley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eagle Ridge at Grand Valley2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1659916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1982331013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 TELLER AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815015107",
            "telephone_number": "970-243-3381",
            "fax_number": "970-243-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 TELLER AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815015107",
            "telephone_number": "970-243-3381",
            "fax_number": "970-243-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE RIDGE OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "720-974-6278"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Ridge at Grand Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.