COMMUNITY MEDICAL GROUP, LLC (NPI# 1073150850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073150850 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEDICAL GROUP, LLC |
| Practice Address |
551 Kokopelli Blvd Unit F Fruita CO 81521-6305 |
| Mailing Address |
Po Box 1727 Grand Junction CO 81502-1727 |
| Practice Telephone | 9708586677 |
| Practice Fax Number | 9708586679 |
| Mailing Telephone | 9702632619 |
| Mailing Fax Number | 9702632691 |
| Enumeration Date | 2019-11-29 |
| Last Update Date | 2019-11-29 |
| Authorized Official Name | CHRISTIAN THOMAS (PRESIDENT/CEO) |
| Authorized Official Telephone | 9706443011 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| CMG Specialty 4 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548807829 | Community Medical Group, LLC | Internal Medicine | 2532 Patterson Rd Ste 9-10, Grand Jct, CO 81505-3604 | 2019-12-05 |
| 1538713136 | Community Medical Group, LLC | Nurse Practitioner | 605 28 1/4 Rd, Grand Junction, CO 81506-6020 | 2019-07-31 |
| 1730505702 | Community Medical Group, LLC | Pediatrics | 601 28 1/4 Rd Unit B, Grand Junction, CO 81506-6022 | 2014-03-13 |
| 1700417425 | Community Medical Group, LLC | Family Medicine | 2373 G Rd Ste 270, Grand Junction, CO 81505-1006 | 2020-01-31 |
| 1457998411 | Community Medical Group, LLC | Family Medicine | 2373 G Rd, Grand Junction, CO 81505-1003 | 2019-12-09 |
| 1720625007 | Community Medical Group, LLC | Specialist | 601 28 1/4 Rd, Grand Junction, CO 81506-6022 | 2019-12-05 |
| 1134766421 | Community Medical Group, LLC | Family Medicine | 2020 N 12th St, Grand Jct, CO 81501-2914 | 2019-12-05 |
| 1205473550 | Community Medical Group, LLC | Family Medicine | 2373 G Rd Ste 240, Grand Junction, CO 81505-1006 | 2019-12-05 |
| 1134766496 | Community Medical Group, LLC | Specialist | 1060 Orchard Ave Unit O, Grand Junction, CO 81501-2997 | 2019-12-05 |
| 1265079545 | Community Medical Group, LLC | Internal Medicine | 2373 G Rd Ste 280, Grand Junction, CO 81505-1006 | 2019-12-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Community Medical Group, LLC | 2351 G Road, Grand Junction, CO 81505 |
| Indiana Business Entities | COMMUNITY MEDICAL GROUP, LLC | 234 East Gray Street, Suite 262, Louisville, KY 40202 |
| Street Address |
551 KOKOPELLI BLVD UNIT F |
| City | FRUITA |
| State | CO |
| Zip Code | 81521-6305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070306 | Lower Valley Hospital Association | Psychiatry & Neurology | 551 Kokopelli Blvd Unit G, -practice Location Npi Only-, Fruita, CO 81521 | 2020-10-14 |
| 1215535943 | Lower Valley Hospital Association | Clinic/Center | 576 Kokopelli Blvd Unit F, -practice Location Npi Only-, Fruita, CO 81521 | 2020-10-14 |
| 1851883284 | Rivers End Dental | Clinic/Center | 532 Raptor Road, Unit B, Fruita, CO 81521 | 2018-06-01 |
| 1427404789 | Path-co, LLC | Day Training, Developmentally Disabled Services | 113 Elderberry Drive, Fruita, CO 81521 | 2016-05-05 |
| 1043518822 | Jonathan E Blaha | Chiropractor | 212 E. Aspen Ave, Fruita, CO 81521 | 2011-03-03 |
| 1881916401 | Diana L Wright | Physician Assistant | 456 Kokopelli Blvd, Suite B, Fruita, CO 81521 | 2010-02-23 |
| 1881878759 | Elizabeth Arena Rook | Internal Medicine | 576 Kokopelli Blvd Unit D-e, Fruita, CO 81521 | 2007-12-27 |
| 1073715348 | Milton Bret Mixon | Speech-Language Pathologist | 551 Kokopelli Blvd Unit B, Fruita, CO 81521 | 2007-05-31 |
| 1306063748 | Scott Douglas Lybrook | Dentist | 551 Kokopelli Blvd, Suite A, Fruita, CO 81521 | 2007-04-19 |
| 1316060684 | Carol Bell Lybrook | Dentist | 551 Kokopelli Ave.,suite A, Fruita, CO 81521 | 2007-04-09 |
| Find all providers in zip 81521 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841458577 | Shane Radcliff | Specialist | 158 S Park Sq, Fruita, CO 81521-2531 | 2008-05-29 |
| 1033516471 | Nicholas Devries | Specialist | 501 Greenbriar St, Fruita, CO 81521-2928 | 2014-12-01 |
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|---|---|---|---|---|
| 1356942171 | Colorado Otolaryngology Associates, LLC | Specialist | 6031 E. Woodmen Rd., Ste. 300, Colorado Springs, CO 80923 | 2020-11-06 |
| 1740881093 | Lori Lea Samuelson | Specialist | 2481 S Xanadu Way Unit A, Aurora, CO 80014-2141 | 2020-11-03 |
| 1619577582 | Steadman Clinic Professional LLC | Specialist | 401 Castle Creek Rd Ste 2100, Aspen, CO 81611-1159 | 2020-10-29 |
| 1336746643 | Kaitlin Sisk | Specialist | 1405 S Broadway St, Boulder, CO 80305-6723 | 2020-10-08 |
| 1669079075 | Colorado Otolaryngology Associates, LLC | Specialist | 6071 E Woodmen Rd Ste 325, Colorado Springs, CO 80923-2612 | 2020-10-08 |
| 1154928950 | Valley View Hospital Association | Specialist | 101 Founders Place, Suites 104 & 105, Aspen, CO 81611 | 2020-10-05 |
| 1689281727 | Nichole Romero | Specialist | 1000 N 9th St Ste 41, Grand Junction, CO 81501-3153 | 2020-09-23 |
| 1043835507 | Boulder Valley Asthma & Allergy Clinics, PC | Specialist | 12000 Pecos St Ste 250, Westminster, CO 80234-3491 | 2020-06-10 |
| 1144845603 | Boulder Valley Asthma & Allergy Clinics, PC | Specialist | 9950 W 80th Ave Ste 14, Arvada, CO 80005-3914 | 2020-06-10 |
| 1437774908 | Boulder Valley Asthma & Allergy Clinics, PC | Specialist | 1660 S Albion St Ste 907, Denver, CO 80222-4046 | 2020-06-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.