NPIMap

Organization Active NPI

Fort Lyon Correctional Facility

  • Clinic/Center
  • Fort Lyon, CO
National Provider Identifier
1629132121
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FORT LYON CORRECTIONAL FACILITY
Practice address
30999 County Rd 15
Fort Lyon, CO 81038
Phone
(719) 456-3222
NPI assigned
Dec 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul O. Lastrella, M.D.
Title
Physician
Phone
(719) 456-3222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

30999 County Rd 15
Fort Lyon, CO 81038

Mailing address

2862 S Circle Dr
Colorado Springs, CO 80906-4101

National Provider Directory

National Provider Directory
Tax ID family
Fort Lyon Correctional Facility103 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

2862 S Circle Dr
Colorado Springs, CO 80906
Phone (719) 226-4511

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629132121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2862 S CIRCLE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30999 COUNTY RD 15",
            "city": "FORT LYON",
            "state": "CO",
            "postal_code": "81038",
            "telephone_number": "719-456-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT LYON CORRECTIONAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LASTRELLA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "719-456-3222",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lyon, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.