NPIMap

Organization Active NPI

Wellcare Inc.

  • Behavior Analyst
  • Colorado Springs, CO
National Provider Identifier
1932707395
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
WELLCARE INC.
Practice address
5446 N Academy Blvd Ste 105
Colorado Springs, CO 80918-3668
Phone
(719) 598-5555
Fax
(719) 388-2030
NPI assigned
Oct 16, 2020
Last updated
Oct 16, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
WELLCARE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Authorized official

Name
Tim Dan Campbell
Title
Owner/Cfo
Phone
(719) 598-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

5446 N Academy Blvd Ste 105
Colorado Springs, CO 80918-3668

Mailing address

5446 N Academy Blvd Ste 105
Colorado Springs, CO 80918-3668
Phone (719) 598-5555

National Provider Directory

National Provider Directory
Tax ID family
Wellcare Inc4 organizations share this tax ID, including this one
Part of
Wellcare Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5446 N Academy Blvd
Ste 105
Colorado Springs, CO 80918
Phone (719) 246-8440

NPI Registry JSON

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602806400000",
    "number": "1932707395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 105",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183668",
            "telephone_number": "719-598-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 105",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183668",
            "telephone_number": "719-598-5555",
            "fax_number": "719-388-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLCARE INC.",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "DAN",
        "authorized_official_title_or_position": "OWNER/CFO",
        "authorized_official_telephone_number": "719-598-5555"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.