ST MARY'S REGIONAL HOSPITAL WOUND CARE CLINIC
NPI 1104430974
Internal Medicine in Grand Junction, CO

Q: What is Intermountain Medical Group Grand Junction, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since August 31, 2020CLIA Certified · 2 labs

2635 N 7TH ST, ENTRANCE 4, GRAND JUNCTION, CO 81501(970) 298-6307(970) 298-7037 Get Directions Write a Review

NPPES record last updated: June 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 28, 2024, Feb 5, 2024, Aug 31, 2020 (3 updates tracked since 2020).

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About St Mary's Regional Hospital Wound Care Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST MARY'S REGIONAL HOSPITAL WOUND CARE CLINIC (NPI 1104430974) is a healthcare organization registered as an internal medicine in Grand Junction, Colorado and active in the NPI registry since August 2020. The organization holds 2 active CLIA laboratory certificates and lists Jon Mcdaniel, Vp Finance Medical Group, as its authorized official.

NPPES Registry Identity

NPI1104430974

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameINTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC

Location Address2635 N 7TH ST, ENTRANCE 4Grand Junction, CO 81501-8209

Mailing Address2635 N 7th St, Entrance 4Grand Junction, CO 81501-8209 · (970) 298-6307 · Fax (970) 298-7037

Phone(970) 298-6307

Fax(970) 298-7037

Organization SubpartYesParent: Intermountain Front Range, Inc.

Authorized OfficialJon McdanielVp Finance Medical Group · (303) 272-0231

Enumeration DateAugust 31, 2020

Last NPPES UpdateJune 28, 20243 updates tracked since enumeration

NPPES CertifiedJune 28, 2024

✔ NPI 1104430974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2635 N 7TH ST, Grand Junction, CO 81501

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Other Names 1

Doing Business AsSt Mary's Regional Hospital Wound Care Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 for Provider-Performed Microscopy Procedures (PPMP) 06D2073275

St Mary's Regional Hospital Nephrology Clinic · Grand Junction, CO

Active · expires Feb 12, 2028

CLIA Number06D2073275

Laboratory TypePhysician Office

Certificate Effective DateFebruary 13, 2026

Certificate Expiration DateFebruary 12, 2028

Laboratory DirectorDr. Matthew P. Cyphers

Laboratory Phone(970) 298-1933

Laboratory LocationSt Mary's Regional Hospital Nephrology Clinic2635 N 7th St, 4th Floor, Grand Junction, CO 81501

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 06D2099015

St Mary's Regional Hospital - Ambulance Service · Grand Junction, CO

Active · expires Dec 20, 2027

CLIA Number06D2099015

Laboratory TypeAmbulance

Certificate Effective DateDecember 21, 2025

Certificate Expiration DateDecember 20, 2027

Laboratory DirectorDr. Tara L. Marshall

Laboratory Phone(970) 298-2149

Laboratory LocationSt Mary's Regional Hospital - Ambulance Service2635 N 7th St, Grand Junction, CO 81501

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

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

MURRAY THIESSEN

Physical Therapist