BOULDER COMMUNITY HEALTH (NPI# 1083799928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083799928 |
| Entity Type | Organization |
| Organization Name | BOULDER COMMUNITY HEALTH |
| Other Organization Name | BOULDER COMMUNITY HOSPITAL |
| Practice Address |
1100 Balsam Ave Boulder CO 80304-3404 |
| Practice Telephone | 3034402273 |
| Practice Fax Number | 3034402435 |
| Mailing Telephone | 3034402273 |
| Mailing Fax Number | 3034402435 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2014-06-03 |
| Authorized Official Name | CAROL J WOODARD (CONTRACTING & PROVIDER RELATIONS) |
| Authorized Official Telephone | 3039383295 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
0909 | CO | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
0909 | CO | Allopathic & Osteopathic Physicians |
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
0909 | CO | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 0909 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 04073086 | 05 |
| Other Name | Type Code |
|---|---|
| Boulder Community Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750981718 | Boulder Community Health | Clinical Medical Laboratory | 6685 Gunpark Dr Ste 100, Boulder, CO 80301-3388 | 2020-10-29 |
| 1225637879 | Boulder Community Health | Clinical Medical Laboratory | 3 Superior Dr Ste 100, Superior, CO 80027-8653 | 2020-10-23 |
| 1649879214 | Boulder Community Health | Clinic/Center | 101 Erie Pkwy Ste 201h, Erie, CO 80516-4072 | 2020-10-23 |
| 1285233882 | Boulder Community Health | Clinic/Center | 4745 Arapahoe Ave Ste 201, Boulder, CO 80303-1080 | 2020-10-23 |
| 1700485372 | Boulder Community Health | Clinic/Center | 2101 Ken Pratt Blvd Ste 104h, Longmont, CO 80501-6568 | 2020-10-23 |
| 1841899416 | Boulder Community Health | Clinic/Center | 1000 W South Boulder Rd Ste 216a, Lafayette, CO 80026-2089 | 2020-10-23 |
| 1346865896 | Boulder Community Health | Clinic/Center | 4743 Arapahoe Ave Ste 201c, Boulder, CO 80303-1128 | 2020-06-10 |
| 1457991473 | Boulder Community Health | Clinic/Center | 101 Erie Pkwy Ste 201f, Erie, CO 80516-4072 | 2020-01-07 |
| 1922659044 | Boulder Community Health | Clinic/Center | 4880 Riverbend Rd Ste 100, Boulder, CO 80301-2622 | 2019-09-20 |
| 1225687965 | Boulder Community Health | Clinic/Center | 4747 Arapahoe Ave, 3 West, Boulder, CO 80303-1131 | 2019-09-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Boulder Community Health | 4747 Arapahoe Avenue, Boulder, CO 80303 |
| Colorado Business Entities | Boulder Community Health Foundation | 4860 Riverbend Road, 2nd Floor, Boulder, CO 80303 |
| Colorado Business Entities | Boulder Community Health Rehab, LLC | 4747 Arapahoe Avenue, Boulder, CO 80303 |
| Colorado Business Entities | Boulder Community Health Sports Medicine Imaging, LLC | 2150 Stadium Drive, 2nd Floor, Boulder, CO 80309 |
| Street Address |
1100 BALSAM AVE |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-3404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942293485 | Jie Mao | Radiology | 1100 Balsam Ave, Radiology, Boulder, CO 80304-3404 | 2005-08-30 |
| 1669987020 | Boulder Senior Adcocates | Social Worker | 1100 Balsam Ave, Boulder, CO 80304-3404 | 2017-12-07 |
| 1740794650 | Suzanne Theresa Conversano | Counselor | 1100 Balsam Ave, Boulder, CO 80304-3404 | 2017-11-30 |
| 1679000798 | Angela Ely | Social Worker | 1100 Balsam Ave, Boulder, CO 80304-3404 | 2017-05-19 |
| 1366807117 | S Lisa Yordy | Social Worker | 1100 Balsam Ave, 4th Floor, Boulder, CO 80304-3404 | 2015-12-22 |
| 1861740532 | Margarita Kurinets | Physician Assistant | 1100 Balsam Ave, 3w, Boulder, CO 80304-3404 | 2012-08-28 |
| 1891012688 | Stephen J. Macdade | Emergency Medicine | 1100 Balsam Ave, Boulder, CO 80304-3404 | 2010-05-03 |
| 1801043039 | Leslie Marie Glover | Registered Nurse | 1100 Balsam Ave, Boulder, CO 80304-3404 | 2008-08-19 |
| 1760648240 | Jennifer Wing-chee Tsoi | Physical Medicine & Rehabilitation | 1100 Balsam Ave, 4th Floor, Boulder, CO 80304-3404 | 2008-08-04 |
| 1083881163 | Ashley Holladay Connolly | Counselor | 1100 Balsam Ave, Boulder Community Hospital, Boulder, CO 80304-3404 | 2008-05-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972748309 | Harry P Ross | Emergency Medicine | 1110 Linden Ave, Boulder, CO 80304-0729 | 2008-12-15 |
| 1194973305 | David W Silver | Emergency Medicine | 3040 5th St, Boulder, CO 80304-2574 | 2008-08-29 |
| 1760546808 | Darvin Smith | Emergency Medicine | 3228 9th St, Boulder, CO 80304-2113 | 2006-12-21 |
| 1710055140 | David Elliott Bright | Emergency Medicine | 2607 Thornbird Pl, Boulder, CO 80304-2496 | 2006-12-01 |
| 1124193453 | Damon J Negri | Emergency Medicine | 4747 Arapahoe Avenue, Boulder, CO 80303-1133 | 2006-11-21 |
| 1699724591 | Bruce Martin Beckord | Emergency Medicine | 7028 Indian Peaks Trail, Boulder, CO 80301 | 2006-05-08 |
| 1053385351 | David P Wiebe | Emergency Medicine | 3922 Promontory Ct, Boulder, CO 80304-1054 | 2006-02-14 |
| 1639142417 | David H. Kruger | Emergency Medicine | 1100 Balsam Ave., Boulder, CO 80304-3404 | 2006-02-10 |
| 1083212989 | Boulder Emergency Physicians PC | Emergency Medicine | 4747 Arapahoe Ave, Boulder, CO 80303-1131 | 2020-10-13 |
| 1588143069 | Sarah Chetham | Emergency Medicine | 4743 Arapahoe Ave Ste 201, Boulder, CO 80303-1128 | 2018-08-07 |
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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.