NPIMap

Organization Active NPI

Colorado Department of Corrections

  • Prison Health Clinic/Center
  • Limon, CO
National Provider Identifier
1386196665
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
COLORADO DEPARTMENT OF CORRECTIONS
Practice address
49030 State Hwy 71
Limon, CO 80826-0001
Phone
(719) 775-7653
Fax
(719) 775-7651
NPI assigned
Nov 2, 2016
Organization subpart
Yes
Parent organization
STATE OF COLORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Dr. Randolph Maul, MD
Title
Chief Medical Officer
Phone
(719) 306-2821

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary
Point of Service 305S00000X DEN.00104436 CO

Addresses

Primary practice location

49030 State Hwy 71
Limon, CO 80826-0001

Mailing address

49030 State Hwy 71
Limon, CO 80826-0001
Phone (719) 775-7653

Other names 1

  • Limon Correctional Facility Other name

National Provider Directory

National Provider Directory
Tax ID family
Colorado State Veterans Nursing Home102 organizations share this tax ID, including this one
Part of
Colorado State Veterans Nursing Home

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

49030 State Road 71
Limon, CO 80826
Phone (719) 775-7653

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1386196665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49030 STATE HWY 71",
            "city": "LIMON",
            "state": "CO",
            "postal_code": "808260001",
            "telephone_number": "719-775-7653",
            "fax_number": "719-775-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49030 STATE HWY 71",
            "city": "LIMON",
            "state": "CO",
            "postal_code": "808260001",
            "telephone_number": "719-775-7653",
            "fax_number": "719-775-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DEPARTMENT OF CORRECTIONS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF COLORADO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "MAUL",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "719-306-2821",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CO",
            "license": "DEN.00104436",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Limon Correctional Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Limon, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.