NPIMap

Organization Active NPI

State of Colorado

Doing business as Otero Junior College Child Development Services

  • Clinical Medical Laboratory
  • La Junta, CO
National Provider Identifier
1396995601
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
06D1089569 Issued in CO
Legal business name
STATE OF COLORADO
Doing business as
Otero Junior College Child Development Services
Practice address
1802 Colorado Ave
La Junta, CO 81050-3400
Phone
(719) 384-3102
Fax
(719) 384-1096
NPI assigned
Sep 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Mr. James Rizzuto
Title
President
Phone
(719) 384-6822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 06D1089569 CO Primary

Addresses

Primary practice location

1802 Colorado Ave
La Junta, CO 81050-3400

Mailing address

1802 Colorado Ave
La Junta, CO 81050-3400
Phone (719) 384-3102

Other identifiers 1

IdentifierTypeStateIssuer
94654395MedicaidCO

Other names 1

  • Otero Junior College Child Development Services Doing business as

National Provider Directory

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

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

1802 Colorado Ave
La Junta, CO 81050
Phone (719) 384-3102

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1396995601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 COLORADO AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810503400",
            "telephone_number": "719-384-3102",
            "fax_number": "719-384-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 COLORADO AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810503400",
            "telephone_number": "719-384-3102",
            "fax_number": "719-384-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF COLORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "RIZZUTO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-384-6822",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CO",
            "license": "06D1089569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94654395",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Otero Junior College Child Development Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Junta, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.