| |
500 W Pacific Ave Telluride CO 81435 | |
(970) 728-3848 | |
(970) 728-3404 |
Full Name | |
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Speciality | Clinic/Center |
Location | 500 W Pacific Ave, Telluride, Colorado |
Authorized Official Name and Position | Marcia T Jennings (BUSINESS OFFICE MANAGER) |
Authorized Official Contact | 8282600476 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1229 Telluride CO 81435-1229 Ph: (970) 728-3848 | 500 W Pacific Ave Telluride CO 81435 Ph: (970) 728-3848 |
NPI Number | 1568406163 |
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Provider Enumeration Date | 06/15/2006 |
Last Update Date | 10/04/2021 |
Medicare PECOS PAC ID | 3678670833 |
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Medicare Enrollment ID | O20070523000069 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568406163 | NPI | - | NPPES |
74925083 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 0393 (Colorado) | Primary |
Provider Name | Kent D Gaylord |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1114030004 PECOS PAC ID: 2769589969 Enrollment ID: I20070523000359 |
Provider Name | Sharon A Grundy |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023043825 PECOS PAC ID: 8123125333 Enrollment ID: I20070523000447 |
Provider Name | Jana Fae Faragher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669693404 PECOS PAC ID: 5890011738 Enrollment ID: I20150311002019 |
Provider Name | Emily Mcgough |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376112631 PECOS PAC ID: 8123417912 Enrollment ID: I20211117000495 |
Provider Name | Anna Turner |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245729508 PECOS PAC ID: 7618360967 Enrollment ID: I20220209000049 |
Provider Name | Lindsay Wright |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1437402377 PECOS PAC ID: 3173867769 Enrollment ID: I20240313002236 |
Provider Name | Samuel Macbride |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1447246095 PECOS PAC ID: 8426070418 Enrollment ID: I20240820001561 |
Provider Name | Michelle Andrea Uriarte |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215774583 PECOS PAC ID: 9638602279 Enrollment ID: I20241104002646 |
Telluride Whole Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 W Colorado Ave, # 207, Telluride, CO 81435 Phone: 970-239-8674 Fax: 970-557-2329 | |
Institute For Altitude Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 W Pacific Ave, Telluride, CO 81435 Phone: 970-728-3848 Fax: 970-728-3404 | |
Telluride Medical Center-primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 South Mahoney, Suite C-1, Telluride, CO 81435 Phone: 970-728-3848 Fax: 970-728-3404 | |