NPIMap

Organization Active NPI

County of Costilla

  • Public Health or Welfare Agency
  • San Luis, CO
National Provider Identifier
1972725455
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
COUNTY OF COSTILLA
Doing business as
Costilla County Public Health Agency
Practice address
233 Main Street
Suite C
San Luis, CO 81152
Phone
(719) 672-3332
Fax
(719) 672-3856
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Authorized official

Name
Vivian B Gallegos, RNNPI 1427317999
Title
Director
Phone
(719) 672-3332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

233 Main Street
Suite C
San Luis, CO 81152

Mailing address

233 Main Street
Suite C
San Luis, CO 81152
Phone (719) 672-3332

Other identifiers 1

IdentifierTypeStateIssuer
04138640MedicaidCO

Other names 1

  • Costilla County Public Health Agency Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1972725455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 MAIN STREET",
            "address_2": "SUITE C",
            "city": "SAN LUIS",
            "state": "CO",
            "postal_code": "81152",
            "telephone_number": "719-672-3332",
            "fax_number": "719-672-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 MAIN STREET",
            "address_2": "SUITE C",
            "city": "SAN LUIS",
            "state": "CO",
            "postal_code": "81152",
            "telephone_number": "719-672-3332",
            "fax_number": "719-672-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF COSTILLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "719-672-3332",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04138640",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costilla County Public Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.