NPIMap

Organization Active NPI

Individual Dynamics

  • Community/Behavioral Health Agency
  • Aurora, CO
National Provider Identifier
1184203754
Registry record updated Apr 2, 2021
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 Ste 200
Aurora, CO 80016-5361
Phone
(720) 295-5559
NPI assigned
Apr 2, 2021
Last updated
Apr 2, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
INDIVIDUAL DYNAMICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Authorized official

Name
Kevin Graves
Title
President/Coo
Phone
(720) 295-5559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

6105 S Main St Ste 200
Aurora, CO 80016-5361

Mailing address

4575 Galley Rd Ste 100D
Colorado Springs, CO 80915-2747
Phone (720) 295-5559

National Provider Directory

National Provider Directory
Tax ID family
Individual Dynamics3 organizations share this tax ID, including this one
Part of
Individual Dynamics

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": "1617321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1184203754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 GALLEY RD STE 100D",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809152747",
            "telephone_number": "720-295-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 S MAIN ST STE 200",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165361",
            "telephone_number": "720-295-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL DYNAMICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIVIDUAL DYNAMICS",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT/COO",
        "authorized_official_telephone_number": "720-295-5559"
    },
    "taxonomies": [
        {
            "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 Apr 2, 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.