Constitution Road Healthcare, Inc.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

CONSTITUTION ROAD HEALTHCARE, INC.

Doing business as

Julia Temple Outpatient Services

Practice address

3401 S Lafayette St
Englewood, CO 80113-2926

Phone

(303) 761-0075

Fax

(303) 761-2967

NPI assigned

Sep 1, 2017

Last updated

Mar 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Soon Burnam

Title

Treasurer

Phone

(949) 540-1249

Specialties & licenses 1

Addresses

Other names 1

• Julia Temple Outpatient Services Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Tax ID family

Constitution Road Healthcare Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Constitution Road Healthcare, Inc.

  dba Julia Temple Outpatient Services

  • Rehabilitation Clinic/Center
  • Englewood, CO
  • NPI 1407496599
  NPD tax ID

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1740708429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27101 PUERTA REAL STE 450",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918566",
            "telephone_number": "949-540-1249",
            "fax_number": "949-540-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 S LAFAYETTE ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132926",
            "telephone_number": "303-761-0075",
            "fax_number": "303-761-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTITUTION ROAD HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-01",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:5291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Julia Temple Outpatient Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald J Conner, MD
• Donald Patrick Connor, DMD
• Jordan Robert Connor, PT
• Jennifer Ann Horan Conrad, MSW, LSW
• Constitution Road Healthcare, Inc. (Julia Temple Outpatient Services)
• Shannon Galbreath Converse, NP
• Natalie Coogan
• Mary Lou Cook-Peck
• Emily Cook
• Richard Allen Cook, PSYD

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Englewood, CO
• Providers in Englewood, CO by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.