NPIMap

Organization Active NPI

Prowers County

  • Non-emergency Medical Transport (VAN)
  • Lamar, CO
National Provider Identifier
1700137445
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
25102567 Issued in CO
Legal business name
PROWERS COUNTY
Practice address
407 E Olive St
Lamar, CO 81052-2842
Phone
(719) 336-8039
NPI assigned
Sep 20, 2012
Last updated
Sep 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Authorized official

Name
Darren Glover
Title
Operations Director
Phone
(719) 336-8039

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 91875714 CO
Non-emergency Medical Transport (VAN) 343900000X 06001481 CO
Non-emergency Medical Transport (VAN) 343900000X 25102567 CO Primary

Addresses

Primary practice location

407 E Olive St
Lamar, CO 81052-2842

Mailing address

407 E Olive St
Lamar, CO 81052-2842

Other identifiers 3

IdentifierTypeStateIssuer
06001481MedicaidCO
25102567MedicaidCO
91875714MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Prowers County3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

407 E Olive St
Lamar, CO 81052
Phone (719) 336-8039

NPI Registry JSON

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1700137445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E OLIVE ST",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810522842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E OLIVE ST",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810522842",
            "telephone_number": "719-336-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROWERS COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "719-336-8039"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CO",
            "license": "91875714",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CO",
            "license": "06001481",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CO",
            "license": "25102567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06001481",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25102567",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91875714",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lamar, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.