Provider Demographics
NPI:1154203933
Name:ALPINE MEDICAL GROUP COLORADO PLLC
Entity type:Organization
Organization Name:ALPINE MEDICAL GROUP COLORADO PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAUGHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-981-6519
Mailing Address - Street 1:999 17TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-2728
Mailing Address - Country:US
Mailing Address - Phone:720-728-5170
Mailing Address - Fax:
Practice Address - Street 1:3210 N ACADEMY BLVD STE 1
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5158
Practice Address - Country:US
Practice Address - Phone:719-733-3131
Practice Address - Fax:719-733-3131
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPINE MEDICAL GROUP COLORADO PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-23
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty