NPIMap

Organization Active NPI

Rocky Mountain Vein Institute, PLLC

Doing business as American Vein & Vascular

  • Vascular & Interventional Radiology Physician
  • Canon City, CO
National Provider Identifier
1992303218
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
ROCKY MOUNTAIN VEIN INSTITUTE, PLLC
Doing business as
American Vein & Vascular
Practice address
109 Latigo LN Ste D
Canon City, CO 81212-8113
Phone
(719) 766-8391
Fax
(719) 545-1829
NPI assigned
Oct 9, 2020
Last updated
Oct 9, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ROCKY MOUNTAIN VEIN INSTITUTE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Authorized official

Name
Gordon F Gibbs, MDNPI 1417929373
Title
Owner/Provider
Phone
(719) 543-8346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

109 Latigo LN Ste D
Canon City, CO 81212-8113

Mailing address

PO Box 7702
Loveland, CO 80537-0702
Phone (970) 663-2742

Other names 1

  • American Vein & Vascular Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100211000128 CO Part B Supplier - Clinic/Group Practice 8325181431 Receives reassigned benefits from 26 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thornton, CO; Pueblo, CO; Parker, CO; Lakewood, CO; Johnstown, CO; Fort Collins, CO; Edwards, CO; Colorado Springs, CO…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Rocky Mountain Vein LLC10 organizations share this tax ID, including this one
Part of
Rocky Mountain Vein LLC

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1992303218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7702",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370702",
            "telephone_number": "970-663-2742",
            "fax_number": "970-342-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LATIGO LN STE D",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128113",
            "telephone_number": "719-766-8391",
            "fax_number": "719-545-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN VEIN INSTITUTE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROCKY MOUNTAIN VEIN INSTITUTE, PLLC",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "719-543-8346",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Vein & Vascular",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.