1699725143 NPI number — MODIVCARE SOLUTIONS, LLC

Table of content: (NPI 1699725143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699725143 NPI number — MODIVCARE SOLUTIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MODIVCARE SOLUTIONS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699725143
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6900 E LAYTON AVE STE 1200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80237-3656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-486-7647
Provider Business Mailing Address Fax Number:
877-352-5640

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6900 E LAYTON AVE STE 1200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80237-3656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-486-7647
Provider Business Practice Location Address Fax Number:
877-352-5640
Provider Enumeration Date:
05/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SAMPSON
Authorized Official First Name:
LARRY
Authorized Official Middle Name:
HEALTH
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
800-486-7647

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 344600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 347B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 347C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 347E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100500601 . This is a "VARIOUS STATE AGENCIES" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 410187100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 191815 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000004686 , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1521 . This is a "ELDERHEALTHTX" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1000014337 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000071637 , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12389 . This is a "ELDERHEALTH PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 81700-035697 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 115788600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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