Individual provider Active NPI

Cristina Sudo, REGISTERED NURSE

  • Registered Nurse
  • Canon City, CO
National Provider Identifier
1013319284
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0178271 Issued in CO
Practice address
749 Dozier Ave
Canon City, CO 81212-2713
Phone
(719) 557-0296
NPI assigned
Sep 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0178271 CO Primary

Addresses

Primary practice location

749 Dozier Ave
Canon City, CO 81212-2713

Mailing address

749 Dozier Ave
Canon City, CO 81212-2713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0178271COMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1013319284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 DOZIER AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 DOZIER AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122713",
            "telephone_number": "719-557-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDO",
        "first_name": "CRISTINA",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "0178271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.