| Tmc-primary Care | |
|
500 W Pacific Ave Telluride CO 81435 | |
| (970) 728-3848 | |
| (970) 728-3404 |
| Full Name | Tmc-primary Care |
|---|---|
| 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 |
|---|---|
| Tmc-primary Care Po Box 1229 Telluride CO 81435-1229 Ph: (970) 728-3848 | Tmc-primary Care 500 W Pacific Ave Telluride CO 81435 Ph: (970) 728-3848 |
| NPI Number | 1568406163 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 10/04/2021 |
| Medicare PECOS PAC ID | 3678670833 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114030004 PECOS PAC ID: 2769589969 Enrollment ID: I20070523000359 |
| Provider Name | Sharon A Grundy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023043825 PECOS PAC ID: 8123125333 Enrollment ID: I20070523000447 |
| Provider Name | Jana Fae Faragher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669693404 PECOS PAC ID: 5890011738 Enrollment ID: I20150311002019 |
| Provider Name | Emily Mcgough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376112631 PECOS PAC ID: 8123417912 Enrollment ID: I20211117000495 |
| Provider Name | Anna Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245729508 PECOS PAC ID: 7618360967 Enrollment ID: I20220209000049 |
| Provider Name | Lindsay Wright |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437402377 PECOS PAC ID: 3173867769 Enrollment ID: I20240313002236 |
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