BRECKENRIDGE MEDICAL CLINIC, LLC
NPI 1376682740
Emergency Medicine in Breckenridge, CO
- Organization
- Emergency Medicine
- CLIA Number: 06D0709238
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 10-31-2025
About BRECKENRIDGE MEDICAL CLINIC, LLC
This page provides the complete NPI Profile along with additional information for Breckenridge Medical Clinic, Llc, a provider established in Breckenridge, Colorado operating as a Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1376682740 assigned on February 2007. The practitioner's primary taxonomy code is 207P00000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. Breckenridge Medical Clinic, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Breckenridge Medical Clinic, Llc. The authorized official of this NPI record is Mr. Paul Chodowski (President/ceo)
- NPI
- 1376682740 Verify this NPI
- Provider Legal Name
- BRECKENRIDGE MEDICAL CLINIC, LLC
- Other Organization Name
- BRECKENRIDGE MEDICAL CLINIC, LLC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 555 SOUTH PARK AVENUE PLAZA 2 BRECKENRIDGE, CO 80424
- Location Phone
- (970) 453-1010
- Mailing Address
- DEPARTMENT 1965 DENVER, CO 80291
- Mailing Phone
- (303) 486-5500
- Mailing Fax
- (303) 486-5501
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-05-2007
- Last Update Date
- 10-20-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| C808784 | MEDICARE PIN (08) | CO |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 06D0709238
- Facility Type
- Community Clinic
- Certificate Effective Date
- April 10, 2023
- Certificate Expiration Date
- October 31, 2025
- Laboratory Director
- MS. JESSICA A. DIRKS
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Breckenridge Medical Clinic, Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
Reviews for BRECKENRIDGE MEDICAL CLINIC, LLC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376682740, enumerated as an "organization" on February 05, 2007.
The provider is located at 555 SOUTH PARK AVENUE PLAZA 2 BRECKENRIDGE, CO 80424 and the phone number is (970) 453-1010.
Emergency Medicine with taxonomy code 207P00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
