Wide Horizon, Inc.

Primary specialty

Religious Nonmedical Health Care InstitutionTaxonomy code 282J00000X

License

0107 Issued in CO

Legal business name

WIDE HORIZON, INC.

Practice address

8900 W 38TH Ave
Wheat Ridge, CO 80033-4204

Phone

(303) 424-4445

Fax

(303) 422-6373

NPI assigned

Jun 10, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. D Brian Boettiger

Title

Executive Director

Phone

(303) 424-4445

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346244969. Details of each certification follow.

• CCN 061990 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 061990

Legal name

WIDE HORIZON

Certification status

Terminated Voluntary: other reason for withdrawal, Jul 1, 2018

Provider type (POS)

Hospital – Religious non-medical health care institution

Participating since

Nov 22, 2000

Last certification

Sep 25, 2012

Beds

24

Ownership / control type

Church

Facility address

8900 West 38TH Avenue
Wheat Ridge, CO 80033

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Susan T Wood

  • Religious Nonmedical Nursing Personnel
  • Wheat Ridge, CO
  • NPI 1710237359
  NPD (past)

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346244969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334204",
            "telephone_number": "303-424-4445",
            "fax_number": "303-422-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334204",
            "telephone_number": "303-424-4445",
            "fax_number": "303-422-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIDE HORIZON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOETTIGER",
        "authorized_official_first_name": "D",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "303-424-4445",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": "CO",
            "license": "0107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Religious Nonmedical Health Care Institution in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Religious Nonmedical Health Care Institution in Colorado

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.