NPIMap

Organization Active NPI

Mesa Developmental Services

  • Case Management Agency
  • Grand Junction, CO
National Provider Identifier
1679696439
Registry record updated Nov 15, 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) 243-3702
Fax
(970) 243-7751
NPI assigned
Apr 9, 2007
Last updated
Nov 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Authorized official

Name
Mr. Grant Jackson
Title
Ceo
Phone
(970) 256-8618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU 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
09145517MedicaidCO

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

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1679696439",
    "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",
            "fax_number": "970-243-7751"
        },
        {
            "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": "970-243-3702",
            "fax_number": "970-243-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA DEVELOPMENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-256-8618",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09145517",
            "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 Nov 15, 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.