NPIMap

Organization Active NPI

Dr Jill D Pollock PC

  • Community/Behavioral Health Agency
  • Pueblo, CO
National Provider Identifier
1003086968
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1020 Issued in CO
Legal business name
DR JILL D POLLOCK PC
Practice address
1115 N Grand Ave
Suite 100
Pueblo, CO 81003-2867
Phone
(719) 562-4414
Fax
(719) 562-4415
NPI assigned
Mar 6, 2008
Last updated
Mar 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Jill Pollock, PSY DNPI 1376614784
Title
President
Phone
(719) 562-4414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1020 CO Primary

Addresses

Primary practice location

1115 N Grand Ave
Suite 100
Pueblo, CO 81003-2867

Mailing address

1115 N Grand Ave
Suite 100
Pueblo, CO 81003-2867
Phone (719) 562-4414

Other identifiers 1

IdentifierTypeStateIssuer
07989536MedicaidCO

National Provider Directory

National Provider Directory

Locations

1115 N Grand Ave
Ste 100
Pueblo, CO 81003
Phone (719) 562-4414

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1003086968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 N GRAND AVE",
            "address_2": "SUITE 100",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032867",
            "telephone_number": "719-562-4414",
            "fax_number": "719-562-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N GRAND AVE",
            "address_2": "SUITE 100",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032867",
            "telephone_number": "719-562-4414",
            "fax_number": "719-562-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JILL D POLLOCK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "POLLOCK",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-562-4414",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CO",
            "license": "1020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07989536",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.