BUCKEYE M, LLC (NPI# 1376182162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376182162 |
| Entity Type | Organization |
| Organization Name | BUCKEYE M, LLC |
| Practice Address |
2121 Mesa Dr Boulder CO 80304-3621 |
| Practice Telephone | 3034424037 |
| Practice Fax Number | 3034422348 |
| Mailing Telephone | 3034424037 |
| Mailing Fax Number | 3034422348 |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2019-12-27 |
| Authorized Official Name | MARY KORETKE (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 3032383838 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Mesa Vista of Boulder | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689665119 | Buckeye M, LLC | Skilled Nursing Facility | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2005-11-03 |
| 1730627183 | Buckeye M, LLC | Skilled Nursing Facility | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2017-02-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Buckeye M, LLC | 12136 West Bayaud Ave, 200, Lakewood, CO 80228 |
| Street Address |
2121 MESA DR |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-3621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689665119 | Buckeye M, LLC | Skilled Nursing Facility | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2005-11-03 |
| 1366948945 | Kristin Oliver Fowler | Occupational Therapy Assistant | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2018-04-03 |
| 1477062586 | Nicole Cherie Rushford | Occupational Therapist | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2017-09-21 |
| 1730627183 | Buckeye M, LLC | Skilled Nursing Facility | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2017-02-06 |
| 1346782661 | Rebecca Drake | Speech-Language Pathologist | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2016-11-17 |
| 1891149167 | Anthony Diongzon | Physical Therapy Assistant | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2016-04-22 |
| 1881866358 | Krystal R Catton | Physical Therapist | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2008-03-25 |
| 1386838985 | Afsaneh Harris | Physical Therapist | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2007-08-28 |
| 1124223524 | Matthew Patrick Shea | Physical Therapist | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2007-06-18 |
| 1598960163 | Carol B. Myers | Occupational Therapist | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2007-06-15 |
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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 | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609996560 | Ssc Boulder Operating Company LLC | Skilled Nursing Facility | 4685 Baseline Rd, Boulder, CO 80303-2601 | 2007-04-01 |
| 1992742258 | Manor Care of Boulder Co LLC | Skilled Nursing Facility | 2800 Palo Pkwy, Boulder, CO 80301-1540 | 2006-06-02 |
| 1689665119 | Buckeye M, LLC | Skilled Nursing Facility | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2005-11-03 |
| 1770574279 | Frasier Meadows Manor, Inc. | Skilled Nursing Facility | 4950 Thunderbird Dr, Boulder, CO 80303-3835 | 2005-11-02 |
| 1730627183 | Buckeye M, LLC | Skilled Nursing Facility | 2121 Mesa Dr, Boulder, CO 80304-3621 | 2017-02-06 |
| 1467516740 | Manorcare Health Services Boulder | Skilled Nursing Facility | 2800 Palo Pkwy, Boulder, CO 80301-1540 | 2006-12-20 |
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| 1639644016 | Katherine and Charles Hover Greenhouses Inc | Skilled Nursing Facility | 1425 Belmont Dr, Longmont, CO 80503 | 2018-10-11 |
| 1043701337 | Center At Centerplace, LLC | Skilled Nursing Facility | 4356 24th Street Rd, Greeley, CO 80634-3330 | 2018-05-23 |
| 1063958338 | Longmont Tc, LLC | Skilled Nursing Facility | 1960 South Fordham St, Longmont, CO 80503 | 2017-01-11 |
| 1447793419 | Suites Fort Collins LLC | Skilled Nursing Facility | 4880 Ziegler Rd, Fort Collins, CO 80528 | 2016-11-23 |
| 1720520729 | Meghan Ricketson | Skilled Nursing Facility | 5962 W Pacific Cir, Lakewood, CO 80227-2583 | 2016-11-08 |
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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.