TABEGUACHE FAMILY & SPORTS MEDICINE
NPI 1417455403
Family Medicine - Sports Medicine in Grand Junction, CO

NPI Status: Active since January 25, 2018

Contact Information

3150 N 12TH ST
GRAND JUNCTION, CO
ZIP 81506
Phone: (970) 256-5201
Fax: (970) 256-5202

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  • Organization
  • Family Medicine
  • Sports Medicine
  • CLIA Number: 06D2104958
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 11-15-2027

About TABEGUACHE FAMILY & SPORTS MEDICINE

This page provides the complete NPI Profile along with additional information for Tabeguache Family & Sports Medicine, a primary care provider established in Grand Junction, Colorado operating as a Family Medicine, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1417455403 assigned on January 2018. The practitioner's primary taxonomy code is 207QS0010X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Tabeguache Family & Sports Medicine operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's other name is Tabeguache Family & Sports Medicine. The authorized official of this NPI record is Beverly J Clark (Credentialing Coordinator)

NPI
1417455403
Provider Legal Name
PRIMARY CARE PARTNERS, INC.
Other Organization Name
TABEGUACHE FAMILY & SPORTS MEDICINE
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
3150 N 12TH ST GRAND JUNCTION, CO 81506
Location Phone
(970) 256-5201
Location Fax
(970) 256-5202
Mailing Address
PO BOX 10700 GRAND JUNCTION, CO 81502
Mailing Phone
(970) 254-2642
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
01-25-2018
Last Update Date
01-04-2022
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A primary care provider (PCP) like Tabeguache Family & Sports Medicine sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

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

Family Medicine Sports Medicine

Taxonomy Code
207QS0010X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BEVERLY J CLARK

Authorized Official Title
CREDENTIALING COORDINATOR
Authorized Official Phone
(970) 254-2642

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
06D2104958
Facility Type
Physician Office
Certificate Effective Date
November 16, 2025
Certificate Expiration Date
November 15, 2027
Laboratory Director
DR. DAN P. SULLIVAN
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Tabeguache Family & Sports Medicine in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1417455403, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
1
Doubled → 2
Pos 4
7
Unchanged
Pos 5
4
Doubled → 8
Pos 6
5
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
4
Unchanged
Pos 9
0
Doubled → 0
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 4 → 8 5 → 10 → 1 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 2 + 7 + 8 + 5 + 1 + 0 + 4 + 0 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1417455403.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Family Medicine
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Pediatrics
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Nurse Practitioner (Family)
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Pharmacy (Community/Retail Pharmacy)
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Psychologist (Clinical)
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Counselor (Professional)
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Social Worker (Clinical)
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Counselor (Mental Health)
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Pharmacist
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Psychologist (Clinical)
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Specialist
3150 N 12TH ST, GARDEN LEVEL
GRAND JUNCTION, CO 81506
Acupuncturist
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Ophthalmology
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Clinic/Center
3150 N 12TH ST, SECOND FLOOR
GRAND JUNCTION, CO 81506
Pharmacist
3150 N 12TH ST, COLORADO STATE INFUSION
GRAND JUNCTION, CO 81506
Prosthetic/Orthotic Supplier
3150 N 12TH ST, SUITE A
GRAND JUNCTION, CO 81506
Registered Nurse (Diabetes Educator)
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Ophthalmology
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Clinical Neuropsychologist
3150 N 12TH ST
GRAND JUNCTION, CO 81506
Psychologist
3150 N 12TH ST
GRAND JUNCTION, CO 81506

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417455403, enumerated as an "organization" on January 25, 2018.

The provider is located at 3150 N 12TH ST GRAND JUNCTION, CO 81506 and the phone number is (970) 256-5201.

Family Medicine with taxonomy code 207QS0010X and a focus in Sports Medicine.