CCRM DONOR EGG BANK LLC – NPI #1104712967
Clinic/Center

A fertility facility, which may be licensed, registered, or certified in some states, that is not hospital-based, where services are provided at a fixed specific location. An Ambulatory Fertility Facility does not provide overnight accommodations. The following fertility procedures may be performed at an Ambulatory Fertility Facility: In Vitro Fertilization (IVF), Gamete Intrafallopian Transfer (GIFT), Embryo Transfer-Thaw (ET-T), Zygote Intrafallopian Transfer (ZIFT), Donor OOCYTE (DO)

Health Care Provider Taxonomy Code for Clinic/Center

CCRM DONOR EGG BANK LLC is an AHC clinic located in LONE TREE, CO. NPPES has assigned the NPI number 1104712967 to CCRM DONOR EGG BANK LLC on June 17, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA0006X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Fertility Facility

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CCRM DONOR EGG BANK LLC below.

NPI Profile for
CCRM DONOR EGG BANK LLC

NPI Number
1104712967
Enumeration Date

(about a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CCRM DONOR EGG BANK LLC
Primary location
10290 RIDGEGATE CIR
LONE TREE, CO 80124-5331
Phone: (303) 788-8300 Fax: (303) 788-8310
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DIANE RAVECH
CHIEF MANAGED CARE OFFICER
Phone: (860) 305-6640
Updated
Certification Date
Jun 17, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA0006X
- Clinic/Center / Ambulatory Fertility Facility (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.