Southern Teller County Health Services District

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0249 Issued in CO

Legal business name

SOUTHERN TELLER COUNTY HEALTH SERVICES DISTRICT

Practice address

700 North a Street
Cripple Creek, CO 80813-0397

Phone

(719) 689-2931

Fax

(719) 689-3702

NPI assigned

Jul 14, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Lawrence Cowan, NHA

Title

Nursing Home Administrator

Phone

(719) 689-2931

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cripple Creek Care Center Doing business as

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549497600000",
    "number": "1629076401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 397",
            "address_2": "700 NORTH A STREET",
            "city": "CRIPPLE CREEK",
            "state": "CO",
            "postal_code": "808130397",
            "telephone_number": "719-689-2931",
            "fax_number": "719-689-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NORTH A STREET",
            "city": "CRIPPLE CREEK",
            "state": "CO",
            "postal_code": "808130397",
            "telephone_number": "719-689-2931",
            "fax_number": "719-689-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TELLER COUNTY HEALTH SERVICES DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2019-02-07",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "NURSING HOME ADMINISTRATOR",
        "authorized_official_telephone_number": "719-689-2931",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "0249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05654215",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cripple Creek Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Rural Family Medical & Dental Care, LLC
• Robert Paul Reid, M.D.
• Root Groove, PLLC
• Jill Elaine Saylor, FNP-BC, NP-C
• Southern Teller County Health Services District
• Southwest Teller County Emergency Medical Services
• Southwest Teller County Emergency Medical Services
• Lance R Stewart
• Amy Terry, RN
• Carla Young, LCMT

• Skilled Nursing Facility in Cripple Creek, CO
• Providers in Cripple Creek, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.