Doc

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

0004895 Issued in CO

Legal business name

DOC

Practice address

57500 E Hwy 50
Canon City, CO 81212-9363

Phone

(719) 269-5081

NPI assigned

Jan 11, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Trudy Ann Sicotte, ACNP

Title

Nurse Practitioner

Phone

(719) 269-5081

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484092800000",
    "number": "1972049245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13955 MURPHY RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808319510",
            "telephone_number": "171-926-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57500 E HWY 50",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129363",
            "telephone_number": "719-269-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-11",
        "last_updated": "2017-01-11",
        "status": "A",
        "authorized_official_last_name": "SICOTTE",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "719-269-5081",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ACNP"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "CO",
            "license": "0004895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORA",
            "identifier": "0004895",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Developmental Opportunities
• Cherilyn Wyquita Dewitt, BS
• Mark Wayne Diamond, D.O.
• Dillon Companies LLC
• Diversicare of Canon City, LLC
• Joanie Amba Dockins, RN
• Brian Leslie Dodds, MD
• Alan Donald, CAC II
• Danika Donovan
• Megan E Drossel, PA-C

• Custodial Care Facility in Canon City, CO
• Providers in Canon City, CO by specialty
• Custodial Care Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.