NPIMap

Organization Active NPI

Mesa Developmental Services

  • Case Management Agency
  • Grand Junction, CO
National Provider Identifier
1679113146
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
MESA DEVELOPMENTAL SERVICES
Practice address
790 Wellington Ave
Grand Junction, CO 81501-6126
Phone
(970) 256-8637
NPI assigned
Jan 13, 2020
Last updated
Aug 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Authorized official

Name
Christopher Brandon Bergquist
Title
Chief Financial Officer
Phone
(970) 256-8603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

790 Wellington Ave
Grand Junction, CO 81501-6126

Mailing address

790 Wellington Ave
Grand Junction, CO 81501-6126
Phone (970) 256-8637

Other identifiers 1

IdentifierTypeStateIssuer
9000142910MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Mesa Developmental Services23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

790 Wellington Ave
Grand Junction, CO 81501
Phone (970) 243-3702

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1679113146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 WELLINGTON AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016126",
            "telephone_number": "970-256-8637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 WELLINGTON AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016126",
            "telephone_number": "970-256-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA DEVELOPMENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-13",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "BERGQUIST",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "BRANDON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "970-256-8603"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000142910",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.