Vanessa Velasquez

Key facts

NPI

1104372218

Entity type

Individual (NPI type 1)

Primary specialty

Homemaker 376J00000X

License

04H512 (CO)

Practice address

13886 Road 33
Mancos, CO 81328-9177

Phone

(970) 882-7008

Fax

(970) 882-4268

NPI assigned

Aug 29, 2016

Sex

Female

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Colorado Compassionate Care Corp Homemaker · Mancos, CO · NPI 1861941957
  NPD (past) Authorized official HOMEMAKER

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 29, 2016.

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1104372218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13886 ROAD 33",
            "city": "MANCOS",
            "state": "CO",
            "postal_code": "813289177",
            "telephone_number": "970-882-7008",
            "fax_number": "970-882-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13886 ROAD 33",
            "city": "MANCOS",
            "state": "CO",
            "postal_code": "813289177",
            "telephone_number": "970-882-7008",
            "fax_number": "970-882-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "CO",
            "license": "04H512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Mancos, CO · Homemaker in Colorado