Arkansas Valley Family Practice, Llc | |
2317 San Juan Ave. Lajunta CO 81050 | |
(719) 383-2325 | |
(719) 383-2327 |
Full Name | Arkansas Valley Family Practice, Llc |
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Speciality | Family Medicine |
Location | 2317 San Juan Ave., Lajunta, Colorado |
Authorized Official Name and Position | Richard K Book (OWNER/PROVIDER) |
Authorized Official Contact | 7193832325 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Arkansas Valley Family Practice, Llc 2317 San Juan Ave. Lajunta CO 81050 Ph: (719) 383-2325 | Arkansas Valley Family Practice, Llc 2317 San Juan Ave. Lajunta CO 81050 Ph: (719) 383-2325 |
NPI Number | 1497938351 |
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Provider Enumeration Date | 12/13/2007 |
Last Update Date | 11/10/2020 |
Medicare PECOS PAC ID | 2365418696 |
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Medicare Enrollment ID | O20040908000419 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497938351 | NPI | - | NPPES |
31830030 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Provider Name | Richard K Book |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1164579199 PECOS PAC ID: 4284686064 Enrollment ID: I20050224000372 |
Provider Name | Missouri Ann Krantz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316495500 PECOS PAC ID: 4385908532 Enrollment ID: I20180516000516 |
Provider Name | Caitlin Philpy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609354414 PECOS PAC ID: 3476988924 Enrollment ID: I20200110002074 |
Provider Name | Sariah Anne Berg |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922640093 PECOS PAC ID: 1052710837 Enrollment ID: I20210527001331 |