NPIMap

Organization Active NPI

San Juan Basin Public Health

  • State or Local Public Health Clinic/Center
  • Durango, CO
National Provider Identifier
1083764443
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
SAN JUAN BASIN PUBLIC HEALTH
Practice address
281 Sawyer Dr
Durango, CO 81303-3409
Phone
(970) 247-5702
Fax
(970) 247-9126
NPI assigned
Jan 10, 2007
Last updated
Jun 11, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SAN JUAN BASIN PUBLIC HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Authorized official

Name
Ms. Liane Jollon, RN
Title
Executive Director
Phone
(970) 247-5702

Specialties & licenses 1

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

Addresses

Primary practice location

281 Sawyer Dr
Durango, CO 81303-3409

Mailing address

281 Sawyer Dr
Durango, CO 81303-3409
Phone (970) 247-5702

Other identifiers 1

IdentifierTypeStateIssuer
04002150MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
San Juan Basin Health Department5 organizations share this tax ID, including this one
Part of
San Juan Basin Health Department

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1083764443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 SAWYER DR",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813033409",
            "telephone_number": "970-247-5702",
            "fax_number": "970-247-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 SAWYER DR",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813033409",
            "telephone_number": "970-247-5702",
            "fax_number": "970-247-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN BASIN PUBLIC HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN JUAN BASIN PUBLIC HEALTH",
        "enumeration_date": "2007-01-10",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "JOLLON",
        "authorized_official_first_name": "LIANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "970-247-5702",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04002150",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.