Colorado Springs Independence Center

Key facts

NPI

1598201618

Entity type

Organization (NPI type 2)

Primary specialty

Home Health Agency 251E00000X

License

9807849 (CO)

Legal business name

COLORADO SPRINGS INDEPENDENCE CENTER

Practice address

729 S Tejon St
Colorado Springs, CO 80903-4041

Phone

(719) 471-8181

Fax

(719) 471-7829

NPI assigned

Jan 12, 2017

Organization subpart

No

Authorized official

Name

Indy Frazee

Title

Chief Executive Officer

Phone

(719) 471-8181

Corporate family (same tax ID) 1

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

• Colorado Springs Independence Center Case Management Agency · Colorado Springs, CO · NPI 1306477690
  NPD tax ID

National Provider Directory

Tax ID family

Colorado Springs Independence Center (2 organizations share this tax ID)

Specialties & licenses

Addresses

Other identifiers

Other names

• The Independence Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 22, 2022.

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1598201618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 S TEJON ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809034041",
            "telephone_number": "719-471-8181",
            "fax_number": "719-471-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 S TEJON ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809034041",
            "telephone_number": "719-471-8181",
            "fax_number": "719-471-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPRINGS INDEPENDENCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "FRAZEE",
        "authorized_official_first_name": "INDY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "719-471-8181"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CO",
            "license": "9807849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05700067",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87600561",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Independence Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Independence Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in Colorado Springs, CO · Home Health Agency in Colorado