Provider Demographics
NPI:1376501387
Name:ALPINE ORTHOPAEDICS & SPORTS MEDICINE PC
Entity type:Organization
Organization Name:ALPINE ORTHOPAEDICS & SPORTS MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-641-6788
Mailing Address - Street 1:112 W SPENCER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2517
Mailing Address - Country:US
Mailing Address - Phone:970-641-6788
Mailing Address - Fax:970-641-0282
Practice Address - Street 1:112 W SPENCER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2517
Practice Address - Country:US
Practice Address - Phone:970-641-6788
Practice Address - Fax:970-641-0282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34655207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01346550Medicaid
COAL634571OtherBCBS
CO187501400OtherOWCP
COAL634571OtherBCBS
COG29758Medicare UPIN
CO5710870001Medicare NSC