Lidia Gonzalez – Case Manager/Care Coordinator

Key facts

NPI: 1982018479
Entity type: Individual (NPI type 1)
Primary specialty: Case Manager/Care Coordinator 171M00000X
License: 0007023 (CO)
Practice address: 30999 County Road 15
Las Animas, CO 81054-9499
Phone: (719) 662-1127
NPI assigned: Jun 12, 2014
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Colorado Coalition for the Homeless Federally Qualified Health Center (FQHC) · Las Animas, CO · NPI 1336563014

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
0007023	CO	MD	Case Manager/Care Coordinator

Practice roles

Organization	Specialty	Status	New patients
Colorado Coalition for the Homeless		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Case Manager/Care Coordinator	171M00000X	0007023	CO	Yes

Addresses

Primary practice location

30999 County Road 15
Las Animas, CO 81054-9499

Mailing address

30999 County Road 15
Las Animas, CO 81054-9499

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 12, 2014.

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1982018479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30999 COUNTY ROAD 15",
            "city": "LAS ANIMAS",
            "state": "CO",
            "postal_code": "810549499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30999 COUNTY ROAD 15",
            "city": "LAS ANIMAS",
            "state": "CO",
            "postal_code": "810549499",
            "telephone_number": "719-662-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LIDIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CO",
            "license": "0007023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Animas, CO

All providers in Las Animas, CO · Case Manager/Care Coordinator in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.