NPIMap

Organization Active NPI

Shadow Mountain Management

  • Respite Care
  • Canon City, CO
National Provider Identifier
1780198598
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
020666 Issued in CO
Legal business name
SHADOW MOUNTAIN MANAGEMENT
Practice address
1401 Phay Ave
Canon City, CO 81212-2303
Phone
(719) 275-8656
Fax
(719) 275-8858
NPI assigned
Dec 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Authorized official

Name
Robin Roberts
Title
Office Manager
Phone
(719) 275-8656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X 020666 CO Primary

Addresses

Primary practice location

1401 Phay Ave
Canon City, CO 81212-2303

Mailing address

1401 Phay Ave
Canon City, CO 81212-2303
Phone (719) 275-8656

Other names 1

  • Hildebrand Care Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hildbrand Care Ctr2 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.

NPI Registry JSON

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1780198598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 PHAY AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122303",
            "telephone_number": "719-275-8656",
            "fax_number": "719-275-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PHAY AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122303",
            "telephone_number": "719-275-8656",
            "fax_number": "719-275-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW MOUNTAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "719-275-8656"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "CO",
            "license": "020666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hildebrand Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.