| Rocky Mountain Family Practice Of Leadville Pc | |
|
735 Us Highway 24 Leadville CO 80461-3978 | |
| (719) 486-0500 | |
| (719) 486-3966 |
| Full Name | Rocky Mountain Family Practice Of Leadville Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 735 Us Highway 24, Leadville, Colorado |
| Authorized Official Name and Position | Lisa P. Zwerdlinger (OWNER) |
| Authorized Official Contact | 7194860500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain Family Practice Of Leadville Pc 735 Us Highway 24 Leadville CO 80461-3978 Ph: (719) 486-0500 | Rocky Mountain Family Practice Of Leadville Pc 735 Us Highway 24 Leadville CO 80461-3978 Ph: (719) 486-0500 |
| NPI Number | 1609814284 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 01/18/2011 |
| Medicare PECOS PAC ID | 4880635804 |
|---|---|
| Medicare Enrollment ID | O20050523000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609814284 | NPI | - | NPPES |
| DD5084 | Other | MEDICARE RAILROAD | |
| 55808255 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sally Ayotte |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295013027 PECOS PAC ID: 8123281532 Enrollment ID: I20120523000104 |
| Provider Name | Kathryn Moulton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477064459 PECOS PAC ID: 8123373230 Enrollment ID: I20180730002716 |
| Provider Name | Lauren Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346713245 PECOS PAC ID: 2365782083 Enrollment ID: I20190315002081 |
| Provider Name | Tamaki Anne Harrold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841629722 PECOS PAC ID: 3678797479 Enrollment ID: I20201216001779 |
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