NPIMap

Organization Active NPI

Southern Colorado Ute Service Unit

Doing business as White Mesa Health Station

  • Federal Public Health Clinic/Center
  • Towaoc, CO
National Provider Identifier
1629344908
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federal Public Health Clinic/CenterTaxonomy code 261QP0904X
Legal business name
SOUTHERN COLORADO UTE SERVICE UNIT
Doing business as
White Mesa Health Station
Practice address
232 Rustling Willow St
Towaoc, CO 81334-0049
Phone
(970) 565-4441
Fax
(970) 565-9110
NPI assigned
Mar 30, 2012
Last updated
Mar 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Mr. Earl David WardNPI 1417051582
Title
Health Center Director
Phone
(970) 565-4441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federal Public Health Clinic/Center 261QP0904X Primary

Addresses

Primary practice location

232 Rustling Willow St
Towaoc, CO 81334-0049

Mailing address

PO Box 49
Towaoc, CO 81334-0049
Phone (970) 565-4441

Other identifiers 4

IdentifierTypeStateIssuer
70000000009MedicaidUT
708000MedicaidAZ
05600002MedicaidCO
G7123MedicaidNM

Other names 1

  • White Mesa Health Station Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Indian Health Service5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1629344908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49",
            "city": "TOWAOC",
            "state": "CO",
            "postal_code": "813340049",
            "telephone_number": "970-565-4441",
            "fax_number": "970-565-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 RUSTLING WILLOW ST",
            "city": "TOWAOC",
            "state": "CO",
            "postal_code": "813340049",
            "telephone_number": "970-565-4441",
            "fax_number": "970-565-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COLORADO UTE SERVICE UNIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "HEALTH CENTER DIRECTOR",
        "authorized_official_telephone_number": "970-565-4441",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70000000009",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "708000",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05600002",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G7123",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Mesa Health Station",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Towaoc, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.