COMMUNITY MEDICAL GROUP, LLC (NPI# 1487291225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487291225 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEDICAL GROUP, LLC |
| Other Organization Name | GRAND JUNCTION PRIMARY CARE IV |
| Practice Address |
551 Kokopelli Blvd 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 | 2019-11-27 |
| Last Update Date | 2020-04-24 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CMG PRIMARY CARE 4 | Doing Business As Name - Organization |
| FRUITA FAMILY MEDICINE | Doing Business As Name - Organization |
| GRAND JUNCTION PRIMARY CARE IV | 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 |
| 1073150850 | Community Medical Group, LLC | Specialist | 551 Kokopelli Blvd Unit F, Fruita, CO 81521-6305 | 2019-11-29 |
| 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 |
| 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 |
| City | FRUITA |
| State | CO |
| Zip Code | 81521-6305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700870680 | Lynda Sue Hamner | Physical Medicine & Rehabilitation | 551 Kokopelli Blvd, Ste J, Fruita, CO 81521-6305 | 2005-09-07 |
| 1982169272 | Lisa Draminski | Speech-Language Pathologist | 551 Kokopelli Blvd, Fruita, CO 81521-6305 | 2019-01-31 |
| 1427284470 | Psych On Heels | Nurse Practitioner | 551 Kokopelli Blvd, Fruita, CO 81521-6305 | 2009-06-04 |
| 1285776864 | Kenneth C Lewis | Anesthesiology | 551 Kokopelli Blvd, Suite K, Fruita, CO 81521-6305 | 2007-02-12 |
| 1891895389 | Thomas Scruton | Physician Assistant | 551 Kokopelli Blvd, Fruita, CO 81521-6305 | 2006-09-24 |
| 1942213475 | Larry D Tice | Neurological Surgery | 551 Kokopelli Blvd, Suite I, Fruita, CO 81521-6305 | 2006-08-14 |
| 1528010527 | Angela K Gao | Family Medicine | 551 Kokopelli Blvd, Suite F, Fruita, CO 81521-6305 | 2006-05-17 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861575730 | Stephen L Ludwig | Family Medicine | 455 Kokopelli Blvd, Unit C, Fruita, CO 81521-8710 | 2006-10-23 |
| 1205800208 | Amy J Archer | Family Medicine | 281 N Plum St, Fruita, CO 81521-2100 | 2006-02-15 |
| 1336122019 | Amy O. Bratteli | Family Medicine | 455 Kokopelli Blvd Ste C, Fruita, CO 81521-8710 | 2005-11-28 |
| 1538626833 | Lower Valley Hospital Association | Family Medicine | 281 N Plum St, Fruita, CO 81521-2100 | 2019-02-23 |
| 1073046488 | Mackenzie Katherine Hartman | Family Medicine | 281 N Plum St, Fruita, CO 81521-2100 | 2017-04-04 |
| 1578095436 | John David Draminski | Family Medicine | 281 N Plum St, Fruita, CO 81521-2100 | 2017-03-30 |
| 1134531627 | Rebecca Levin | Family Medicine | 455 Kokopelli Blvd Ste C, Fruita, CO 81521-8710 | 2014-06-02 |
| 1972932622 | Primary Care Partners, Inc. | Family Medicine | 455 Kokopelli Blvd Ste C, Fruita, CO 81521-8710 | 2013-11-04 |
| 1407177579 | Vanessa Mcclellan | Family Medicine | 281 N Plum St, Fruita, CO 81521-2100 | 2010-06-11 |
| 1609190206 | Lower Valley Hospital Association | Family Medicine | 300 W Ottley Ave, Fruita, CO 81521-2118 | 2010-03-25 |
| Find all providers in FRUITA | ||||
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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.