| Basin Clinic Inc | |
|
421 Adams St Naturita CO 81422-5018 | |
| (970) 865-2665 | |
| (970) 865-2674 |
| Full Name | Basin Clinic Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 421 Adams St, Naturita, Colorado |
| Authorized Official Name and Position | Christina Pierce (DIRECTOR) |
| Authorized Official Contact | 9708652665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Basin Clinic Inc Po Box 340 Naturita CO 81422-0340 Ph: (970) 865-2665 | Basin Clinic Inc 421 Adams St Naturita CO 81422-5018 Ph: (970) 865-2665 |
| NPI Number | 1114974037 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 04/28/2021 |
| Medicare PECOS PAC ID | 9032101068 |
|---|---|
| Medicare Enrollment ID | O20040331000883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114974037 | NPI | - | NPPES |
| 020250699 | Other | EEOIC | |
| C383208 | Other | CO | MEDICARE PART B |
| BA643081 | Other | CO | ANTHEM BLUE CROSS |
| 18434576 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| Provider Name | Tiffany Fonte-ordonez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588754006 PECOS PAC ID: 0840261764 Enrollment ID: I20040804000706 |
| Provider Name | April L Randle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679780613 PECOS PAC ID: 1456345057 Enrollment ID: I20090225000505 |
| Provider Name | David P Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851575062 PECOS PAC ID: 3577616184 Enrollment ID: I20090729000850 |
| Provider Name | Mary A Kus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720765589 PECOS PAC ID: 6305294828 Enrollment ID: I20231122000542 |