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INTERMOUNTAIN HEALTH HEART & VASCULAR - WEST PARK CARDIOLOGY
NPI 1780355156
Internal Medicine - Cardiovascular Disease in Grand Junction, CO

Active since September 24, 2021CLIA 06D2232789 · Waiver
360 W PARK DR, GRAND JUNCTION, CO 81505(970) 298-3050(970) 744-5367 Get Directions Write a Review

NPPES record last updated: June 28, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 28, 2024, Jan 3, 2024, Sep 24, 2021 (3 updates tracked since 2021).

About Intermountain Health Heart & Vascular - West Park Cardiology NPPES

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

INTERMOUNTAIN HEALTH HEART & VASCULAR - WEST PARK CARDIOLOGY (NPI 1780355156) is a healthcare organization registered as a cardiovascular disease in Grand Junction, Colorado and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through August 16, 2027 and lists Jon Mcdaniel, Vp Finance Med Group, as its authorized official.

NPPES Registry Identity

NPI1780355156
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameINTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC
Location Address360 W PARK DRGrand Junction, CO 81505-1448
Mailing Address500 Eldorado Blvd Ste 6300Broomfield, CO 80021-3422 · (303) 272-0566
Phone(970) 298-3050
Fax(970) 744-5367
Organization SubpartYesParent: Intermountain Front Range, Inc.
Authorized OfficialJon McdanielVp Finance Med Group · (303) 272-0231
Enumeration DateSeptember 24, 2021
Last NPPES UpdateJune 28, 20243 updates tracked since enumeration
NPPES CertifiedJune 28, 2024
✔ NPI 1780355156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
360 W PARK DR, Grand Junction, CO 81505
Open in Google Maps ↗

Other Names 1

Doing Business AsIntermountain Health Heart & Vascular - West Park Cardiology

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 06D2232789

Intermountain Health Heart & Vascular West Park Cardiology · Grand Junction, CO
Active · expires Aug 16, 2027
CLIA Number06D2232789
Laboratory TypePhysician Office
Certificate Effective DateAugust 17, 2025
Certificate Expiration DateAugust 16, 2027
Laboratory DirectorDr. Muhammad Azzouz
Laboratory Phone(970) 298-3050
Laboratory LocationIntermountain Health Heart & Vascular West Park Cardiology360 West Park Drive, Grand Junction, CO 81505
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 10

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

DR. MARY E WILLY DO
Pediatrics
360 W PARK DR, SUITE 201
GRAND JUNCTION, CO 81505
Mesa County (970) 609-7337
EMMA CRICK
Physician Assistant
360 W PARK DR
GRAND JUNCTION, CO 81505
Mesa County (970) 298-3050
DR. CARL L ROUCH M.D.
Internal Medicine (Interventional Cardiology)
360 W PARK DR
GRAND JUNCTION, CO 81505
Mesa County (970) 244-2482
ALEXANDRA LEVESQUE
Physician Assistant
360 W PARK DR
GRAND JUNCTION, CO 81505
Mesa County (970) 298-3050
ZACHARY ROBERT PERKINS
Nurse Practitioner
360 W PARK DR
GRAND JUNCTION, CO 81505
Mesa County (970) 298-3050
ANNEST SYNN NOWAK & MUBARAK PROFESSIONAL LLC
Specialist
360 W PARK DR
GRAND JUNCTION, CO 81505
Mesa County (970) 852-4847
DIVLEEN SIDHU
Internal Medicine (Cardiovascular Disease)
360 W PARK DR
GRAND JUNCTION, CO 81505
Mesa County (970) 298-3050
KEVIN VIPUL DESAI
Internal Medicine (Cardiovascular Disease)
360 W PARK DR
GRAND JUNCTION, CO 81505
Mesa County (303) 272-0644

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 Intermountain Medical Group Grand Junction, LLC's NPI number?

The NPI number for Intermountain Medical Group Grand Junction, LLC is 1780355156. It was assigned to this organization in the NPPES registry on September 24, 2021. The provider is doing business as Intermountain Health Heart & Vascular - West Park Cardiology.

Where is Intermountain Medical Group Grand Junction, LLC located?

Intermountain Medical Group Grand Junction, LLC is located at 360 W Park Dr, Grand Junction, CO 81505. The listed phone number is (970) 298-3050.

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Intermountain Medical Group Grand Junction, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D2232789) is associated with this NPI, valid through August 16, 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 Intermountain Medical Group Grand Junction, LLC was last updated on June 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.