Organization Active NPI

Five Star Quality Care-Colorado LLC

  • Skilled Nursing Facility
  • Colorado Springs, CO
National Provider Identifier
1972558054
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1146 Issued in CO
Legal business name
FIVE STAR QUALITY CARE-COLORADO LLC
Doing business as
Springs Village Care Center
Practice address
110 W Van Buren St
Colorado Springs, CO 80907-6713
Phone
(719) 475-8686
Fax
(719) 475-1223
NPI assigned
May 24, 2006
Organization subpart
Yes
Parent organization
FIVE STAR QUALITY CARE-COLORADO LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Authorized official

Name
Katherine E Potter
Title
President & Chief Executive Officer
Phone
(617) 796-8387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1146 CO Primary

Addresses

Primary practice location

110 W Van Buren St
Colorado Springs, CO 80907-6713

Mailing address

110 W Van Buren St
Colorado Springs, CO 80907-6713
Phone (719) 475-8686

Other identifiers 1

IdentifierTypeStateIssuer
13359240MedicaidCO

Other names 1

  • Springs Village Care Center Doing business as

National Provider Directory

National Provider Directory
Part of
Five Star Quality Care-Colorado LLC

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1972558054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W VAN BUREN ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076713",
            "telephone_number": "719-475-8686",
            "fax_number": "719-475-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W VAN BUREN ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076713",
            "telephone_number": "719-475-8686",
            "fax_number": "719-475-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR QUALITY CARE-COLORADO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR QUALITY CARE-COLORADO LLC",
        "enumeration_date": "2006-05-24",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "1146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13359240",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springs Village Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 26, 2019; 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.