Organization Active NPI

Southwest Colorado Mental Health Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Telluride, CO
National Provider Identifier
1124764774
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOUTHWEST COLORADO MENTAL HEALTH CENTER INC
Practice address
238 E. Colorado Ave, Second Floor
Suite 9
Telluride, CO 81435
Phone
(970) 252-3200
Fax
(970) 369-1261
NPI assigned
May 6, 2022
Organization subpart
Yes
Parent organization
SOUTHWEST COLORADO MENTAL HEALTH CENTER INC DBA AXIS HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Authorized official

Name
Shelly Burke
Title
Ceo
Phone
(000) 000-0000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

238 E. Colorado Ave, Second Floor
Suite 9
Telluride, CO 81435

Mailing address

PO Box 1328
Durango, CO 81302-1328
Phone (970) 335-2342

Other names 1

  • Axis Health System Telluride Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326001177 CO Part B Supplier - Clinic/Group Practice 9133011802 Receives reassigned benefits from 95 practitioners
46 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gunnison, CO; Montrose, CO; Norwood, CO; Pagosa Springs, CO; Telluride, CO; Crested Butte, CO; Durango, CO; Dove Creek, CO…

Other NPIs on the same Medicare enrollment 41

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 41

National Provider Directory

National Provider Directory
Tax ID family
Pinon Mesa Guidance Cen50 organizations share this tax ID, including this one
Part of
Pinon Mesa Guidance Cen

Other organizations with this tax ID 49

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

View all 49

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651795200000",
    "number": "1124764774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1328",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813021328",
            "telephone_number": "970-335-2342",
            "fax_number": "970-335-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 E. COLORADO AVE, SECOND FLOOR",
            "address_2": "SUITE 9",
            "city": "TELLURIDE",
            "state": "CO",
            "postal_code": "81435",
            "telephone_number": "970-252-3200",
            "fax_number": "970-369-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST COLORADO MENTAL HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST COLORADO MENTAL HEALTH CENTER INC DBA AXIS HEALTH SYSTEM",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "000-000-0000"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axis Health System Telluride",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Telluride, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.