Active NPI
San Juan Sentry, LLC
- Taxi
- Cortez, CO
National Provider Identifier
1922479583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Taxi
- License
- 55823
- Legal business name
- SAN JUAN SENTRY, LLC
- Practice address
- 108 S Chestnut St
Cortez, CO 81321-3532 - Phone
- (970) 565-6911
- Fax
- (970) 565-4480
- NPI assigned
- Oct 8, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Edward E Gilbert
- Title
- Managing Member
- Phone
- (970) 560-4633
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Taxi | 344600000X | 55823 | CO | Primary |
Addresses
Primary practice location
108 S Chestnut St
Cortez, CO 81321-3532
Mailing address
PO Box 669
Cortez, CO 81321-4240
Phone (970) 565-6911
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86203339 | Medicaid | CO | |
| 39335836 | Medicaid | CO |
Other names 1
- CORTEZ CAB
National Provider Directory
National Provider Directory- Tax ID family
- San Juan Sentry LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Taxi
- Durango, CO
- NPI 1205208089
Locations
108 S Chestnut St
Cortez, CO 81321
Phone (970) 565-6911
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Taxi
- Durango, CO
- NPI 1205208089
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1633132800000",
"number": "1922479583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 669",
"city": "CORTEZ",
"state": "CO",
"postal_code": "813214240",
"telephone_number": "970-565-6911",
"fax_number": "970-565-4480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 S CHESTNUT ST",
"city": "CORTEZ",
"state": "CO",
"postal_code": "813213532",
"telephone_number": "970-565-6911",
"fax_number": "970-565-4480"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAN JUAN SENTRY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-10-08",
"last_updated": "2021-10-02",
"certification_date": "2021-10-02",
"status": "A",
"authorized_official_last_name": "GILBERT",
"authorized_official_first_name": "EDWARD",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "970-560-4633"
},
"taxonomies": [
{
"code": "344600000X",
"taxonomy_group": "",
"desc": "Taxi",
"state": "CO",
"license": "55823",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "86203339",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39335836",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CORTEZ CAB",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CORTEZ CAB",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Cortez, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.