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1033020342 NPI number — BISON CIRCLE COLLABORATIVE

NPI Number: 1033020342
Health Care Provider/Practitioner: BISON CIRCLE COLLABORATIVE

Information about “1033020342” NPI (BISON CIRCLE COLLABORATIVE) exists in 1033020342 in HTML format HTML  |  1033020342 in plain Text format TXT  |  1033020342 in PDF (Portable Document Format) PDF  |  1033020342 in an XML format XML  formats.

NPI Number : 1033020342 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033020342",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BISON CIRCLE COLLABORATIVE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1500 N GRANT ST # 11592",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DENVER",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80203-1859",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "720-235-8036",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "15 S 33RD ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOULDER",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80305-3423",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "720-235-8036",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/15/2026",
    "LastUpdateDate": "09/15/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SMITH",
    "AuthorizedOfficialFirstName": "RAYL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGING MEMBER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MS, BCBA",
    "AuthorizedOfficialTelephoneNumber": "541-941-4392",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103K00000X",
        "TaxonomyName": "Behavior Analyst",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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