| Mountain Medical Center Llc | |
|
295 Sherman St Ridgway CO 81432-0298 | |
| (970) 626-5123 | |
| (970) 626-9783 |
| Full Name | Mountain Medical Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 295 Sherman St, Ridgway, Colorado |
| Authorized Official Name and Position | Joel Thomas Gates (OWNER) |
| Authorized Official Contact | 9706265123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Medical Center Llc Po Box 298 Ridgway CO 81432-0298 Ph: (970) 626-5123 | Mountain Medical Center Llc 295 Sherman St Ridgway CO 81432-0298 Ph: (970) 626-5123 |
| NPI Number | 1689642571 |
|---|---|
| Provider Enumeration Date | 03/08/2006 |
| Last Update Date | 01/26/2010 |
| Medicare PECOS PAC ID | 8729054374 |
|---|---|
| Medicare Enrollment ID | O20040907000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689642571 | NPI | - | NPPES |
| 12330787 | Medicaid | CO | |
| 642998 | Other | CO | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35376 (Colorado) | Primary |
| Provider Name | Joel Thomas Gates |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477642569 PECOS PAC ID: 4082648241 Enrollment ID: I20050927000257 |
| Provider Name | Nathan S Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518920313 PECOS PAC ID: 4284651670 Enrollment ID: I20190507002733 |
| Provider Name | Jacklyn S Hardin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235764143 PECOS PAC ID: 2365872454 Enrollment ID: I20200507000534 |
| Provider Name | Alison Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558953109 PECOS PAC ID: 4183023872 Enrollment ID: I20210601000157 |
Dave Sherwood Family Medicine Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 570 Palomino Trl, Ridgway, CO 81432 Phone: 970-626-4370 Fax: 970-626-3442 | |
Cedar Point Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 295 Sherman St, Ridgway, CO 81432 Phone: 970-626-5123 Fax: 970-249-5029 | |
Cedar Point Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 295 Sherman St, Ridgway, CO 81432 Phone: 970-249-7751 Fax: 970-541-9806 |