NPIMap

Organization Active NPI

Sample Supports

  • Community/Behavioral Health Agency
  • Loveland, CO
National Provider Identifier
1447618475
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SAMPLE SUPPORTS
Practice address
1528 N Lincoln Ave
Unit 2
Loveland, CO 80538-3849
Phone
(720) 684-6102
NPI assigned
Feb 4, 2016
Last updated
Feb 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Carmen Sample
Title
Ceo
Phone
(720) 684-6102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1528 N Lincoln Ave
Unit 2
Loveland, CO 80538-3849

Mailing address

1528 N Lincoln Ave
Unit 2
Loveland, CO 80538-3849

Other identifiers 1

IdentifierTypeStateIssuer
40078256MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Sample Supports LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

1528 N Lincoln Ave
Ste 2
Loveland, CO 80538

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1447618475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 N LINCOLN AVE",
            "address_2": "UNIT 2",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805383849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 N LINCOLN AVE",
            "address_2": "UNIT 2",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805383849",
            "telephone_number": "720-684-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMPLE SUPPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "SAMPLE",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-684-6102"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40078256",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.