NPIMap

Organization Active NPI

Southern Colorado Developmental Disabilities Services, Inc

  • Case Management Agency
  • Trinidad, CO
National Provider Identifier
1427596642
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SOUTHERN COLORADO DEVELOPMENTAL DISABILITIES SERVICES, INC
Practice address
1205 Congress Dr
Trinidad, CO 81082-1283
Phone
(719) 846-4409
Fax
(719) 846-4543
NPI assigned
Feb 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Authorized official

Name
Mr. Duane Roy
Title
Executive Director
Phone
(719) 846-4409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

1205 Congress Dr
Trinidad, CO 81082-1283

Mailing address

1205 Congress Dr
Trinidad, CO 81082-1283
Phone (719) 846-4409

Other identifiers 2

IdentifierTypeStateIssuer
09140070MedicaidCO
09144247MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Southern Colorado Developmental Disabilities Services Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1427596642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 CONGRESS DR",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810821283",
            "telephone_number": "719-846-4409",
            "fax_number": "719-846-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 CONGRESS DR",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810821283",
            "telephone_number": "719-846-4409",
            "fax_number": "719-846-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COLORADO DEVELOPMENTAL DISABILITIES SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-08",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "DUANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-846-4409",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09140070",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09144247",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinidad, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.