Active NPI
Susan Grant
- Community Health Worker
- Fountain, CO
National Provider Identifier
1275985681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 460 Winebrook Way
Fountain, CO 80817-2356 - Phone
- (719) 322-2618
- NPI assigned
- Jul 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
460 Winebrook Way
Fountain, CO 80817-2356
Mailing address
460 Winebrook Way
Fountain, CO 80817-2356
Phone (719) 322-2618
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468022400000",
"number": "1275985681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "460 WINEBROOK WAY",
"city": "FOUNTAIN",
"state": "CO",
"postal_code": "808172356",
"telephone_number": "719-322-2618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "460 WINEBROOK WAY",
"city": "FOUNTAIN",
"state": "CO",
"postal_code": "808172356",
"telephone_number": "719-322-2618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-09",
"last_updated": "2016-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.