Organization Active NPI

South Sycamore Manor Cares LLC

  • Assisted Living Facility
  • Littleton, CO
National Provider Identifier
1164097838
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SOUTH SYCAMORE MANOR CARES LLC
Practice address
6365 S Sycamore St
Littleton, CO 80120-3034
Phone
(303) 834-5646
NPI assigned
May 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Chirag Shah
Title
Member
Phone
(303) 834-5646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

6365 S Sycamore St
Littleton, CO 80120-3034

Mailing address

PO Box 270523
Louisville, CO 80027-5008

Other identifiers 1

IdentifierTypeStateIssuer
23V262MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Fax

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1164097838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270523",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800275008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6365 S SYCAMORE ST",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801203034",
            "telephone_number": "303-834-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SYCAMORE MANOR CARES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "CHIRAG",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "303-834-5646"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23V262",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "Secure fax",
            "address_1": "6365 S Sycamore St",
            "city": "Littleton",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801203034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.