NPIMap

Organization Active NPI

Countryside Health & Wellness LLC

  • Chiropractor
  • Westminster, CO
National Provider Identifier
1811266125
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6683 Issued in CO
Legal business name
COUNTRYSIDE HEALTH & WELLNESS LLC
Practice address
1499 W 120TH Ave
Suite 130
Westminster, CO 80234-2995
Phone
(303) 255-6980
Fax
(303) 255-6899
NPI assigned
Dec 16, 2011
Last updated
Dec 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Authorized official

Name
Dr. Shane W Lear, DCNPI 1891088118
Title
Owner
Phone
(303) 255-6980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6683 CO Primary

Addresses

Primary practice location

1499 W 120TH Ave
Suite 130
Westminster, CO 80234-2995

Mailing address

1499 W 120TH Ave
Suite 130
Westminster, CO 80234-2995
Phone (303) 255-6980

National Provider Directory

National Provider Directory

Locations

12001 Pecos St
Westminster, CO 80234
Phone (303) 255-6980

1499 W 120th Ave
Ste 130
Westminster, CO 80234
Phone (303) 255-6980

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1811266125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 W 120TH AVE",
            "address_2": "SUITE 130",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342995",
            "telephone_number": "303-255-6980",
            "fax_number": "303-255-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 W 120TH AVE",
            "address_2": "SUITE 130",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342995",
            "telephone_number": "303-255-6980",
            "fax_number": "303-255-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "LEAR",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-255-6980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; 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.