Central Colorado Prosthetics and Orthotics, LLC

Key facts

NPI

1861997322

Entity type

Organization (NPI type 2)

Primary specialty

Prosthetic/Orthotic Supplier 335E00000X

License

20186000250 (CO)

Legal business name

CENTRAL COLORADO PROSTHETICS AND ORTHOTICS, LLC

Practice address

28350 County Road 317 Unit 8
Buena Vista, CO 81211-9261

Phone

(303) 396-9557

NPI assigned

Mar 27, 2018

Organization subpart

No

Authorized official

Name

Lara Knudson, MSPO, CPO

Title

Owner

Phone

(303) 396-9557

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 27, 2018.

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1861997322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 BELLOWS RD",
            "city": "HARTSEL",
            "state": "CO",
            "postal_code": "804498553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28350 COUNTY ROAD 317 UNIT 8",
            "city": "BUENA VISTA",
            "state": "CO",
            "postal_code": "812119261",
            "telephone_number": "303-396-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COLORADO PROSTHETICS AND ORTHOTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "KNUDSON",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-396-9557",
        "authorized_official_credential": "MSPO, CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CO",
            "license": "20186000250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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