DESERT RIVER FAMILY MEDICINE, LLC
NPI 1023773611
Family Medicine in Canon City, CO
About Desert River Family Medicine, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DESERT RIVER FAMILY MEDICINE, LLC (NPI 1023773611) is a healthcare organization registered as a family medicine in Canon City, Colorado and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through December 21, 2027 and lists Tara L Robicheaux, Business Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Desert River Family Medicine, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Desert River Family Medicine, LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 06D2246242
Desert River Family Medicine · Canon City, COFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Desert River Family Medicine, LLC's NPI number?
The NPI number for Desert River Family Medicine, LLC is 1023773611. It was assigned to this organization in the NPPES registry on November 8, 2021.
Where is Desert River Family Medicine, LLC located?
Desert River Family Medicine, LLC is located at 1335 Phay Ave Ste A, Canon City, CO 81212. The listed phone number is (719) 285-8890.
What is Desert River Family Medicine, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Desert River Family Medicine, LLC enrolled in Medicare?
Yes. Desert River Family Medicine, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Desert River Family Medicine, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Desert River Family Medicine, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Desert River Family Medicine, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 06D2246242) is associated with this NPI, valid through December 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Desert River Family Medicine, LLC was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Desert River Family Medicine, Llc · NPI 1023773611
Family Medicine organization in Canon City, Colorado. Organization record, active in the CMS NPPES registry since November 8, 2021.
## Identity
- **NPI:** 1023773611 (Entity type: Organization)
- **Enumerated:** November 8, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Tara Robicheaux, BUSINESS MANAGER
## Practice location
- **Address:** 1335 PHAY AVE STE A, Canon City, CO 81212-2349
- **Phone:** (719) 285-8890
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Family Practice) reassign Medicare billing to this organization (form CMS-855R); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 7, 2025
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1023773611) · Data from the CMS NPPES public registry.