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DESERT RIVER FAMILY MEDICINE, LLC
NPI 1023773611
Family Medicine in Canon City, CO

Active since November 08, 2021CLIA 06D2246242 · Waiver
1335 PHAY AVE STE A, CANON CITY, CO 81212(719) 285-8890 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 7, 2025, Dec 18, 2024, May 24, 2022 and 3 more (6 updates tracked since 2021).

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

NPI1023773611
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDESERT RIVER FAMILY MEDICINE, LLC
Location Address1335 PHAY AVE STE ACanon City, CO 81212-2349
Mailing Address1335 Phay Ave Ste ACanon City, CO 81212-2349 · (719) 285-8890
Phone(719) 285-8890
Organization SubpartNo
Authorized OfficialTara L RobicheauxBusiness Manager · (719) 285-8890
Enumeration DateNovember 8, 2021
Last NPPES UpdateMay 7, 20256 updates tracked since enumeration
NPPES CertifiedMay 7, 2025
✔ NPI 1023773611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Family Planning, Non-SurgicalTaxonomy 261QF0050X
1335 PHAY AVE STE A, Canon City, CO 81212
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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, CO
Active · expires Dec 21, 2027
CLIA Number06D2246242
Laboratory TypePhysician Office
Certificate Effective DateDecember 22, 2025
Certificate Expiration DateDecember 21, 2027
Laboratory DirectorRyan S. Rahman
Laboratory Phone(719) 285-8890
Laboratory LocationDesert River Family Medicine1335 Phay Ave, Suite A, Canon City, CO 81212
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RYAN S RAHMAN M.D.
Family Medicine
1335 PHAY AVE STE A
CANON CITY, CO 81212
Fremont County (719) 285-8890
JAMES F. REPPERT, M.D.
Internal Medicine
1335 PHAY AVE STE A
CANON CITY, CO 81212
Fremont County (719) 275-4151
JAMES FRED REPPERT M.D.
Internal Medicine
1335 PHAY AVE STE A
CANON CITY, CO 81212
Fremont County (719) 275-4151
DESERT RIVER DIRECT, PLLC
Family Medicine
1335 PHAY AVE STE A
CANON CITY, CO 81212
Fremont County (719) 285-8890
GUIDZENGACO
Internal Medicine
1335 PHAY AVE STE A
CANON CITY, CO 81212
Fremont County (719) 275-4151
STEPHEN LEE BARBEE M.D.
Internal Medicine
1335 PHAY AVE STE A
CANON CITY, CO 81212
Fremont County (719) 275-4151

Frequently 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.

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 15 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.