| Colorado Mountain Medical, Pc | |
|
50 Buck Creek Road Suite 200 Avon CO 81620 | |
| (970) 926-6340 | |
| (970) 926-6348 |
| Full Name | Colorado Mountain Medical, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 50 Buck Creek Road, Avon, Colorado |
| Authorized Official Name and Position | Janet Engle (PRESIDENT) |
| Authorized Official Contact | 9709266340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colorado Mountain Medical, Pc Po Box 5850 C/o Credentialing - Lisa Kerstiens Eagle CO 81631-5850 Ph: (970) 926-6340 | Colorado Mountain Medical, Pc 50 Buck Creek Road Suite 200 Avon CO 81620 Ph: (970) 926-6340 |
| NPI Number | 1083675102 |
|---|---|
| Provider Enumeration Date | 03/29/2006 |
| Last Update Date | 09/29/2016 |
| Medicare PECOS PAC ID | 4486633674 |
|---|---|
| Medicare Enrollment ID | O20040720001045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083675102 | NPI | - | NPPES |
| 04005617 | Medicaid | CO |
| Provider Name | Stewart L Greisman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831201607 PECOS PAC ID: 4486542081 Enrollment ID: I20040305000847 |
| Provider Name | Stephen P. Laird |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962474452 PECOS PAC ID: 4385601145 Enrollment ID: I20041217000754 |
| Provider Name | Edward L Dent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225030075 PECOS PAC ID: 5395794366 Enrollment ID: I20050117000402 |
| Provider Name | Gale V Santa Maria |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295722098 PECOS PAC ID: 0345279410 Enrollment ID: I20050809000537 |
| Provider Name | Ronald C Strahan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1346246618 PECOS PAC ID: 7618862301 Enrollment ID: I20050914001274 |
| Provider Name | Susan A Vickerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750383667 PECOS PAC ID: 3971537945 Enrollment ID: I20050920000939 |
| Provider Name | Jennifer M Bettenhausen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548262066 PECOS PAC ID: 3173557055 Enrollment ID: I20050920001116 |
| Provider Name | Diane Voytko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043212525 PECOS PAC ID: 8426082314 Enrollment ID: I20050920001210 |
| Provider Name | Steven A Yarberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598759540 PECOS PAC ID: 3678507571 Enrollment ID: I20050920001321 |
| Provider Name | Eric E Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639149651 PECOS PAC ID: 9830123744 Enrollment ID: I20050920001344 |
| Provider Name | Kent A Petrie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265402283 PECOS PAC ID: 0547294456 Enrollment ID: I20050920001358 |
| Provider Name | Jean S Hadley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780686329 PECOS PAC ID: 0749214500 Enrollment ID: I20050921000416 |
| Provider Name | Jonathan C Feeney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346235116 PECOS PAC ID: 4284668609 Enrollment ID: I20050923000943 |
| Provider Name | Keith P Samuels |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144264243 PECOS PAC ID: 9638166416 Enrollment ID: I20060105000772 |
| Provider Name | Janet M Engle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275503682 PECOS PAC ID: 0446262638 Enrollment ID: I20060710000052 |
| Provider Name | Mark R Stephens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407858137 PECOS PAC ID: 9537172705 Enrollment ID: I20060712000004 |
| Provider Name | Stephen J Mohr |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033252580 PECOS PAC ID: 7315021664 Enrollment ID: I20080225000631 |
| Provider Name | Pamela A. Bock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497708390 PECOS PAC ID: 4688737109 Enrollment ID: I20090109000428 |
| Provider Name | Brooks F Bock |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174583900 PECOS PAC ID: 4183536543 Enrollment ID: I20090109000619 |
| Provider Name | Cheryl A Kohn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932391919 PECOS PAC ID: 9133282551 Enrollment ID: I20090112000518 |
| Provider Name | Mindy Cooper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659301851 PECOS PAC ID: 8628966967 Enrollment ID: I20090115000226 |
| Provider Name | Rebecca E Laird |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063568749 PECOS PAC ID: 5092870477 Enrollment ID: I20090218000593 |
| Provider Name | Connie K Wolf |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861529869 PECOS PAC ID: 8921164740 Enrollment ID: I20090303000592 |
| Provider Name | William A Foutz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427097690 PECOS PAC ID: 1153477153 Enrollment ID: I20090916000347 |
| Provider Name | Jerrilu Atkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811970239 PECOS PAC ID: 7517097405 Enrollment ID: I20100621000336 |
| Provider Name | Aaron M Loyd |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1306029590 PECOS PAC ID: 5395879282 Enrollment ID: I20140731000379 |
| Provider Name | Andrea P Hutchinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669740452 PECOS PAC ID: 1052630738 Enrollment ID: I20150430001211 |
| Provider Name | Tessa M Beal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700148525 PECOS PAC ID: 8224335666 Enrollment ID: I20160329002726 |
| Provider Name | Laurel Reinhart Stearns |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1356491393 PECOS PAC ID: 6800196809 Enrollment ID: I20160627001333 |
| Provider Name | Allisa R Corsbie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801240304 PECOS PAC ID: 7416237532 Enrollment ID: I20161207001553 |
| Provider Name | Keith Lee Rapp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366405029 PECOS PAC ID: 8224936703 Enrollment ID: I20161213002124 |
| Provider Name | Dana E Walenta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083167563 PECOS PAC ID: 2365716115 Enrollment ID: I20170919000129 |
| Provider Name | Justine M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417360637 PECOS PAC ID: 2264653088 Enrollment ID: I20180815002614 |
Guy J. Kovacevich, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 142 Beaver Creek Place, Avon, CO 81620 Phone: 970-949-5434 Fax: 970-949-0376 | |
Beaver Creek Medical Center - Service Of Vail Health Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1280 Village Rd Ste 324c, Avon, CO 81620 Phone: 970-949-0800 | |
Avon Outpatient Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Buck Creek Rd, Suite 100, Avon, CO 81620 Phone: 970-949-6100 | |
Howard Head Sports Medicine At Avon Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 Riverfront Ln Unit C107, Avon, CO 81620 Phone: 970-845-9600 | |
Alpine Chiropractic & Soft Tissue Diagnostic Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 41191 Us Hwy 6 & 24, Avon, CO 81620 Phone: 970-949-6244 | |
Colorado Mountain Medical, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Buck Creek Rd Ste 300, Avon, CO 81620 Phone: 970-926-6340 Fax: 970-926-6348 |