NPIMap

Organization Active NPI

Conejos County Hospital Corporation Long Term Care Unit

  • Nursing Facility/Intermediate Care Facility
  • La Jara, CO
National Provider Identifier
1184683278
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
CONEJOS COUNTY HOSPITAL CORPORATION LONG TERM CARE UNIT
Practice address
19021 State Hwy 885
La Jara, CO 81140
Phone
(719) 274-6058
Fax
(719) 274-6003
NPI assigned
Mar 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Brigitte Inge Foust
Title
Hipaa Privacy Security Officer
Phone
(719) 274-6029

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X NU Primary

Addresses

Primary practice location

19021 State Hwy 885
La Jara, CO 81140

Mailing address

PO Box 639
16021 State Hwy 285
La Jara, CO 81140
Phone (719) 274-6058

Other identifiers 1

IdentifierTypeStateIssuer
47174838MedicaidCO

Other names 1

  • Conejos County Hospital District Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Conejos County Hospital Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184683278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "address_2": "16021 STATE HWY 285",
            "city": "LA JARA",
            "state": "CO",
            "postal_code": "81140",
            "telephone_number": "719-274-6058",
            "fax_number": "719-274-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19021 STATE HWY 885",
            "city": "LA JARA",
            "state": "CO",
            "postal_code": "81140",
            "telephone_number": "719-274-6058",
            "fax_number": "719-274-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONEJOS COUNTY HOSPITAL CORPORATION LONG TERM CARE UNIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOUST",
        "authorized_official_first_name": "BRIGITTE",
        "authorized_official_middle_name": "INGE",
        "authorized_official_title_or_position": "HIPAA PRIVACY SECURITY OFFICER",
        "authorized_official_telephone_number": "719-274-6029",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47174838",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conejos County Hospital District",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in La Jara, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.