Assurance Support Services Agency

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

ASSURANCE SUPPORT SERVICES AGENCY

Practice address

11059 E Bethany Dr Ste 105
Aurora, CO 80014-2617

Phone

(720) 420-9049

Fax

(720) 368-5299

NPI assigned

Jan 29, 2020

Last updated

Jun 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gormah Pinky Kolleh

Title

Ceo

Phone

(720) 420-9049

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Assurance Support Services Agency3 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.

• Assurance Support Services Agency

  • Transportation Broker
  • Aurora, CO
  • NPI 1053967257
  NPD tax ID
• Assurance Support Services Agency

  • Case Management Agency
  • Aurora, CO
  • NPI 1821454398
  NPD tax ID

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1053942094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24789 E FLORIDA AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800186054",
            "telephone_number": "215-888-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11059 E BETHANY DR STE 105",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142617",
            "telephone_number": "720-420-9049",
            "fax_number": "720-368-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSURANCE SUPPORT SERVICES AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "KOLLEH",
        "authorized_official_first_name": "GORMAH",
        "authorized_official_middle_name": "PINKY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-420-9049"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821454398",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Aurora, CO by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.