NPIMap

Organization Active NPI

Pueblo Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
National Provider Identifier
1013261023
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PUEBLO COMMUNITY HEALTH CENTER
Practice address
625 N Monument Ave
Pueblo, CO 81001-5706
Phone
(719) 543-8711
Fax
(719) 543-5340
NPI assigned
Oct 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Authorized official

Name
Donald Moore
Title
Ceo
Phone
(719) 543-8711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

625 N Monument Ave
Pueblo, CO 81001-5706

Mailing address

110 E Routt Ave
Pueblo, CO 81004-2117
Phone (719) 543-8711

Other names 1

  • Risley School Based Wellness Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Pueblo Community Health17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

625 N Monument Ave
Pueblo, CO 81001

Practitioners & affiliated clinicians

Practitioners 2

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": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1013261023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ROUTT AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042117",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N MONUMENT AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810015706",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "719-543-8711"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Risley School Based Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 19, 2012; 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.