Bear Creek Senior Living

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BEAR CREEK SENIOR LIVING

Practice address

1685 S 21St St
Colorado Springs, CO 80904-5123

Phone

(719) 329-1774

Fax

(719) 329-1695

NPI assigned

Aug 21, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Luke Allen Pettiette, NHA, RN

Title

Executive Director

Phone

(719) 329-1774

Specialties & licenses 1

Addresses

Other names 1

• Brookdale Bear Creek Former legal business name

Electronic endpoints 1

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1114574449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 S 21ST ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809045123",
            "telephone_number": "719-329-1774",
            "fax_number": "719-329-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 S 21ST ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809045123",
            "telephone_number": "719-329-1774",
            "fax_number": "719-329-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR CREEK SENIOR LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "PETTIETTE",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-329-1774",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA, RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LPettiette@Stellarliving.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1685 S 21st St",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809045123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Brookdale Bear Creek",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Margot Lathan Bean, LCSW
• Matthew G Bean, DO
• Tami L Bean, MSW, LCSW
• Bear Creek Dental
• Bear Creek Family Medicine, Prof. LLC
• Crystal Beard-Odom, LMT
• Brittany Beard
• Aimee Marcel Bearden, NP-C
• Ellis Beardsley, DO
• Skylur Beardsley

• Skilled Nursing Facility in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.