GRAND MESA FAMILY PRACTICE – NPI #1013103373
Clinic/Center

GRAND MESA FAMILY PRACTICE is an AHC clinic located in DELTA, CO. NPPES has assigned the NPI number 1013103373 to GRAND MESA FAMILY PRACTICE on September 20, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “GRAND MESA FAMILY PRACTICE” is a dba name, the actual legal business name for this organization is KIECA MD PLLC. The primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was previously updated about 18 years ago on Jan 16, 2008. 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 GRAND MESA FAMILY PRACTICE below.

NPI Profile for
KIECA MD PLLC

NPI Number
1013103373
Enumeration Date

(more than 18 years 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
KIECA MD PLLC
Doing Business As (dba): GRAND MESA FAMILY PRACTICE
Primary location
2050 SOUTH MAIN
UNIT B
DELTA, CO 81416
Phone: (970) 874-4473 Fax: (970) 874-8681
Mailing address
105 SE FRONTIER AVE
SUITE A-1
CEDAREDGE, CO 81413-4020
Phone: (970) 856-3747 Fax: (970) 856-4814
Organization Subpart
No
Authorized Official
JENNIFER CRAIG
OWNER
Phone: (970) 856-3747
Updated
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
261QP2300X
- Clinic/Center / Primary Care (Primary)		 CO 40224

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.