NPIMap

Organization Active NPI

Lifespan Psychiatry of Colorado

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Junction, CO
National Provider Identifier
1831915958
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LIFESPAN PSYCHIATRY OF COLORADO
Practice address
637 North Ave
Grand Junction, CO 81501-7513
Phone
(970) 579-0003
Fax
(970) 433-7671
NPI assigned
Nov 25, 2024
Last updated
Nov 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Carrie ShahbahramiNPI 1972070498
Title
Owner
Phone
(970) 579-0003

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

637 North Ave
Grand Junction, CO 81501-7513

Mailing address

2140 N 12TH St
Grand Junction, CO 81501-2916
Phone (970) 579-0003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210121000197 CO Part B Supplier - Clinic/Group Practice 0749694495 Receives reassigned benefits from 14 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO; Delta, CO

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

637 North Ave
Grand Junction, CO 81501

Practitioners & affiliated clinicians

Practitioners 12

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": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1831915958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 N 12TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012916",
            "telephone_number": "970-579-0003",
            "fax_number": "970-433-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 NORTH AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815017513",
            "telephone_number": "970-579-0003",
            "fax_number": "970-433-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN PSYCHIATRY OF COLORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-24",
        "status": "A",
        "authorized_official_last_name": "SHAHBAHRAMI",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-579-0003"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 25, 2024; 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.