Provider Demographics
NPI:1851074140
Name:COMPASSIONATE CONCIERGE PHYSICIANS, LLC
Entity Type:Organization
Organization Name:COMPASSIONATE CONCIERGE PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-859-9722
Mailing Address - Street 1:5390 SAINT VRAIN RD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8764
Mailing Address - Country:US
Mailing Address - Phone:303-859-9722
Mailing Address - Fax:
Practice Address - Street 1:1551 PROFESSIONAL LN UNIT 180
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6970
Practice Address - Country:US
Practice Address - Phone:720-986-0850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASSIONATE CONCIERGE PHYSICIANS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-11
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty