Integracare LLC

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

Legal business name

INTEGRACARE LLC

Practice address

5300 W 29TH St
Greeley, CO 80634-8399

Phone

(970) 353-6800

Fax

(970) 506-4202

NPI assigned

Aug 3, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Cameron Wallace

Title

Manager

Phone

(970) 977-6239

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343952000000",
    "number": "1063768455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816320065",
            "telephone_number": "970-977-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 W 29TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806348399",
            "telephone_number": "970-353-6800",
            "fax_number": "970-506-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRACARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "CAMERON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "970-977-6239",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.