Provider Demographics
NPI:1801045554
Name:ANIMAS ORTHOPEDIC ASSOCIATES & SPORTS MEDICINE, P.C.
Entity Type:Organization
Organization Name:ANIMAS ORTHOPEDIC ASSOCIATES & SPORTS MEDICINE, P.C.
Other - Org Name:ANIMAS ORTHOPEDIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRINCETON
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-259-3020
Mailing Address - Street 1:575 RIVERGATE
Mailing Address - Street 2:SUITE105
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7487
Mailing Address - Country:US
Mailing Address - Phone:970-259-3020
Mailing Address - Fax:970-259-3020
Practice Address - Street 1:575 RIVERGATE
Practice Address - Street 2:SUITE105
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7487
Practice Address - Country:US
Practice Address - Phone:970-259-3020
Practice Address - Fax:970-259-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6353970001Medicare NSC