Individual provider Active NPI

James Shoff, DMD

  • General Practice Dentistry
  • Walsenburg, CO
National Provider Identifier
1982087508
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
00202897 Issued in CO
Practice address
624 Main St
Walsenburg, CO 81089-2136
Phone
(719) 695-1004
NPI assigned
Jul 1, 2015
Last updated
May 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7552921-9922 UT
General Practice Dentistry 1223G0001X 00202897 CO Primary

Addresses

Primary practice location

624 Main St
Walsenburg, CO 81089-2136

Mailing address

5435 Backglen Dr
Colorado Springs, CO 80906-8600
Phone (801) 615-3593

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00202897COMDGeneral Practice Dentistry
7552921-9922UTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1982087508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 BACKGLEN DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809068600",
            "telephone_number": "801-615-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MAIN ST",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810892136",
            "telephone_number": "719-695-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOFF",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7552921-9922",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00202897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walsenburg, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.