NPIMap

Organization Active NPI

Individual Dynamics

  • Community/Behavioral Health Agency
  • Aurora, CO
National Provider Identifier
1124338314
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
INDIVIDUAL DYNAMICS
Practice address
6105 S Main St
Suite 200
Aurora, CO 80016-5360
Phone
(720) 295-5559
NPI assigned
Oct 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Authorized official

Name
Mr. Joe Vaccaro
Title
Director
Phone
(720) 295-5559

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

6105 S Main St
Suite 200
Aurora, CO 80016-5360

Mailing address

4575 Galley Rd
Suite 400a
Colorado Springs, CO 80915-2750
Phone (720) 295-5559

National Provider Directory

National Provider Directory
Tax ID family
Individual Dynamics3 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.

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1124338314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 GALLEY RD",
            "address_2": "SUITE 400A",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809152750",
            "telephone_number": "720-295-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 S MAIN ST",
            "address_2": "SUITE 200",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165360",
            "telephone_number": "720-295-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL DYNAMICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "VACCARO",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "720-295-5559",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.