SILVERTON AND SAN JUAN CO CLINIC (NPI# 1811513880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811513880 |
| Entity Type | Organization |
| Organization Name | SILVERTON AND SAN JUAN CO CLINIC |
| Practice Address |
1315 Snowden Street Silverton CO 81433 |
| Mailing Address |
Po Box 964 Silverton CO 81433-0964 |
| Practice Telephone | 9703875114 |
| Practice Fax Number | 9703875036 |
| Mailing Telephone | 9703875114 |
| Mailing Fax Number | 9703875037 |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2020-06-24 |
| Authorized Official Name | THERESA BROKERING (BOARD MEMBER) |
| Authorized Official Telephone | 9706183913 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FREE CLINIC NO INSURANCE BILLING | 12345 | 01 |
| Other Name | Type Code |
|---|---|
| Silverton Clinic | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SILVERTON AND SAN JUAN CO CLINIC | 1315 Snowden St, Silverton, CO 81433-5108 |
| Street Address |
1315 SNOWDEN STREET |
| City | SILVERTON |
| State | CO |
| Zip Code | 81433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194975383 | San Juan County Public Health Service | Public Health or Welfare | 1315 Snowden Street, Silverton, CO 81433 | 2008-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366931024 | Miners Family Dental, LLC | Dentist | 1315 Snowden Ste. 4b, Silverton, CO 81433 | 2018-05-08 |
| 1780086231 | Lois Mackenzie | Registered Nurse | 1315 Snowden, Silverton, CO 81433 | 2014-09-16 |
| 1902179625 | Theresa A Brokering | Registered Nurse | 1315 Snowden St., Silverton, CO 81433 | 2012-02-10 |
| 1003213596 | San Juan County | Public Health or Welfare | 1315 Snowden St., Silverton, CO 81433 | 2014-11-26 |
| 1689702615 | Silverton San Juan County Ambulance Association Inc. | Ambulance | 1450 Greene Street, Silverton, CO 81433-0493 | 2007-03-01 |
| 1649636010 | Rebecca B Joyce | Registered Nurse | 1315 Snowden St., Silverton, CO 81433-0619 | 2016-01-14 |
| 1982049540 | Karen M Srebacic | Driver | 1043 Mineral Street, Silverton, CO 81433-0683 | 2013-05-08 |
| 1215105093 | Anthony Suruda | Preventive Medicine | 969 Reese Street, Silverton, CO 81433-0850 | 2008-02-14 |
| 1467073213 | Christopher Blankenship | Social Worker | 1612 Mineral Street, Unit A, Silverton, CO 81433-8143 | 2020-05-04 |
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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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.