NPIMap

Organization Active NPI

Developmental Disabilities Center

Doing business as Imagine

  • Psychiatry Physician
  • Lafayette, CO
National Provider Identifier
1174532204
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DEVELOPMENTAL DISABILITIES CENTER
Doing business as
Imagine
Practice address
1400 Dixon Avenue
Lafayette, CO 80026-2790
Phone
(303) 665-7789
Fax
(303) 665-2648
NPI assigned
Aug 7, 2006
Last updated
Jan 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Mr. John Nevins
Title
Cfo
Phone
(303) 665-7789

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Cognitive & Behavioral Psychologist 103TB0200X NU
Clinical Social Worker 1041C0700X NU
Registered Nurse 163W00000X NU
Neurodevelopmental Disabilities Physician 2084P0005X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1400 Dixon Avenue
Lafayette, CO 80026-2790

Mailing address

1400 Dixon Avenue
Lafayette, CO 80026-2790
Phone (303) 665-7789

Other names 1

  • Imagine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1174532204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 DIXON AVENUE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262790",
            "telephone_number": "303-665-7789",
            "fax_number": "303-665-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 DIXON AVENUE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262790",
            "telephone_number": "303-665-7789",
            "fax_number": "303-665-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL DISABILITIES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "NEVINS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-665-7789",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imagine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.