| Csmn Operations Boulder | |
|
1360 Walnut St Ste 110 Boulder CO 80302-5399 | |
| (970) 693-0015 | |
| Not Available |
| Full Name | Csmn Operations Boulder |
|---|---|
| Speciality | Clinic/Center |
| Location | 1360 Walnut St Ste 110, Boulder, Colorado |
| Authorized Official Name and Position | Ashley Blair Elder (REVENUE CYCLE ADMINISTRATOR) |
| Authorized Official Contact | 7372471223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Csmn Operations Boulder 2205 Cordillera Way Edwards CO 81632-6290 Ph: (970) 693-0015 | Csmn Operations Boulder 1360 Walnut St Ste 110 Boulder CO 80302-5399 Ph: (970) 693-0015 |
| NPI Number | 1982327334 |
|---|---|
| Provider Enumeration Date | 09/21/2022 |
| Last Update Date | 03/28/2023 |
| Medicare PECOS PAC ID | 5890169726 |
|---|---|
| Medicare Enrollment ID | O20230316000914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982327334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Joshua Joseph Rodgers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477879237 PECOS PAC ID: 5597051789 Enrollment ID: I20220429000546 |
| Provider Name | Hannah Adair Scarborough |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750844213 PECOS PAC ID: 6305271263 Enrollment ID: I20240415002752 |
| Provider Name | Jerald Westendorf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265903918 PECOS PAC ID: 3870835804 Enrollment ID: I20240722003713 |
| Provider Name | John Kubai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740752062 PECOS PAC ID: 6305288523 Enrollment ID: I20240724001063 |
| Provider Name | Caleb Jayce Steen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033949136 PECOS PAC ID: 4284175266 Enrollment ID: I20240918000066 |
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