NPIMap

Organization Active NPI

Otero County Health Department

  • State or Local Public Health Clinic/Center
  • La Junta, CO
National Provider Identifier
1023215472
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
License
04413092 Issued in CO
Legal business name
OTERO COUNTY HEALTH DEPARTMENT
Practice address
13 West Third St.
Room 111
La Junta, CO 81050-1691
Phone
(719) 383-3040
Fax
(719) 383-3060
NPI assigned
Jun 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lorene Nelson, RN
Title
Nursing Supervisor
Phone
(719) 383-3040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X 04413092 CO Primary

Addresses

Primary practice location

13 West Third St.
Room 111
La Junta, CO 81050-1691

Mailing address

13 West Third St.
Room 111
La Junta, CO 81050-1691
Phone (719) 383-3040

Other identifiers 3

IdentifierTypeStateIssuer
07396187MedicaidCO
07321771MedicaidCO
07452618MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Otero County Health Dep3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13 W 3rd St
Ste 111
La Junta, CO 81050
Phone (719) 383-3040

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023215472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 WEST THIRD ST.",
            "address_2": "ROOM 111",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810501691",
            "telephone_number": "719-383-3040",
            "fax_number": "719-383-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 WEST THIRD ST.",
            "address_2": "ROOM 111",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810501691",
            "telephone_number": "719-383-3040",
            "fax_number": "719-383-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTERO COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "LORENE",
        "authorized_official_title_or_position": "NURSING SUPERVISOR",
        "authorized_official_telephone_number": "719-383-3040",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "CO",
            "license": "04413092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07396187",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07321771",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07452618",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Junta, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.