Provider Demographics
NPI:1821528837
Name:COLUMBINE HEARING CARE, LLC
Entity Type:Organization
Organization Name:COLUMBINE HEARING CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTY
Authorized Official - Middle Name:
Authorized Official - Last Name:JESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:303-895-5589
Mailing Address - Street 1:5808 S RAPP ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-1942
Mailing Address - Country:US
Mailing Address - Phone:303-895-5589
Mailing Address - Fax:
Practice Address - Street 1:5808 S RAPP ST STE 102
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-1942
Practice Address - Country:US
Practice Address - Phone:720-689-7989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO344231H00000X, 237600000X
261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty