NPIMap

Organization Active NPI

Digestive Health Associates Professional Corporation

  • Specialist
  • Durango, CO
National Provider Identifier
1376522615
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
B65222 Issued in CO
Legal business name
DIGESTIVE HEALTH ASSOCIATES PROFESSIONAL CORPORATION
Practice address
2 Burnett CT Ste 100
Durango, CO 81301-3647
Phone
(970) 385-4022
Fax
(970) 385-4337
NPI assigned
Jan 13, 2006
Last updated
Oct 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
Cassandra Peacock
Title
Billing Manager
Phone
(970) 385-4022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X B65222 CO Primary

Addresses

Primary practice location

2 Burnett CT Ste 100
Durango, CO 81301-3647

Mailing address

2 Burnett CT Ste 100
Durango, CO 81301-3647
Phone (970) 385-4022

Other identifiers 2

IdentifierTypeStateIssuer
100007417OtherCORAILROAD MEDICARE
9000150560MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000905 CO Part B Supplier - Clinic/Group Practice 6507756970 Receives reassigned benefits from 6 practitioners
Practice locations: Durango, CO

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2 Burnett Ct
Ste 100
Durango, CO 81301
Phone (970) 385-4022

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1376522615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BURNETT CT STE 100",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813013647",
            "telephone_number": "970-385-4022",
            "fax_number": "970-385-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BURNETT CT STE 100",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813013647",
            "telephone_number": "970-385-4022",
            "fax_number": "970-385-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE HEALTH ASSOCIATES PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "970-385-4022"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "B65222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100007417",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000150560",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.