NPIMap

Organization Active NPI

Bijou Healthcare LLC

  • Assisted Living Facility
  • Colorado Springs, CO
National Provider Identifier
1255853735
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
23R219 Issued in CO
Legal business name
BIJOU HEALTHCARE LLC
Doing business as
Medallion Villas
Practice address
1719 E Bijou St
Colorado Springs, CO 80909-5736
Phone
(719) 381-4972
Fax
(719) 385-0429
NPI assigned
Jul 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 23R219 CO Primary

Addresses

Primary practice location

1719 E Bijou St
Colorado Springs, CO 80909-5736

Mailing address

27101 Puerta Real Ste 450
Mission Viejo, CA 92691-8566
Phone (949) 540-1249

Other names 1

  • Medallion Villas Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bijou Healthcare LLC3 organizations share this tax ID, including this one

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": "1500249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1255853735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27101 PUERTA REAL STE 450",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918566",
            "telephone_number": "949-540-1249",
            "fax_number": "949-540-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 E BIJOU ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095736",
            "telephone_number": "719-381-4972",
            "fax_number": "719-385-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIJOU HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-17",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23R219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medallion Villas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medallion Villas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.