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ROCKY MOUNTAIN CLINICS LLC
NPI 1922724707
Family Medicine - Addiction Medicine in Boulder, CO

Active since October 13, 2022CLIA 06D2166135 · Waiver
4730 TABLE MESA DR STE A100, BOULDER, CO 80305(720) 476-7957 Get Directions Write a Review

NPPES record last updated: March 5, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 5, 2024, Mar 14, 2023, Oct 13, 2022 (3 updates tracked since 2022).

About Rocky Mountain Clinics Llc NPPES

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

ROCKY MOUNTAIN CLINICS LLC (NPI 1922724707) is a healthcare organization registered as an addiction medicine in Boulder, Colorado and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through May 12, 2027 and lists Sabrina Gibson, Cfo, as its authorized official.

NPPES Registry Identity

NPI1922724707
Entity TypeOrganization
Primary Taxonomy207QA0401X
Legal Business NameROCKY MOUNTAIN CLINICS LLC
Location Address4730 TABLE MESA DR STE A100Boulder, CO 80305-5574
Mailing Address1120 E Elizabeth St Ste G2Fort Collins, CO 80524-4044
Phone(720) 476-7957
Organization SubpartNo
Authorized OfficialSabrina GibsonCfo · (970) 493-9193
Enumeration DateOctober 13, 2022
Last NPPES UpdateMarch 5, 20243 updates tracked since enumeration
NPPES CertifiedMarch 5, 2024
✔ NPI 1922724707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
Also ListedFamily MedicineTaxonomy 207Q00000X
4730 TABLE MESA DR STE A100, Boulder, CO 80305
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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 06D2166135

Rocky Mountain Clinic - Boulder · Boulder, CO
Active · expires May 12, 2027
CLIA Number06D2166135
Laboratory TypePhysician Office
Certificate Effective DateMay 13, 2025
Certificate Expiration DateMay 12, 2027
Laboratory DirectorDr. Clark S. Mccoy
Laboratory Phone(720) 476-7957
Laboratory LocationRocky Mountain Clinic - Boulder4720 Table Mesa Dr, Suite B-100, Boulder, CO 80303
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DR. EDITH ISRAEL PSYD
Psychologist
4730 TABLE MESA DR STE A100, STE 102
BOULDER, CO 80305
Boulder County (303) 444-3823

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 Rocky Mountain Clinics LLC's NPI number?

The NPI number for Rocky Mountain Clinics LLC is 1922724707. It was assigned to this organization in the NPPES registry on October 13, 2022.

Where is Rocky Mountain Clinics LLC located?

Rocky Mountain Clinics LLC is located at 4730 Table Mesa Dr Ste A100, Boulder, CO 80305. The listed phone number is (720) 476-7957.

What is Rocky Mountain Clinics LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

Does Rocky Mountain Clinics LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D2166135) is associated with this NPI, valid through May 12, 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 Rocky Mountain Clinics LLC was last updated on March 5, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.