NPIMap

Organization Active NPI

Colorado Department of Corrections

  • Exclusive Provider Organization
  • Pueblo, CO
National Provider Identifier
1033430442
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
19512 Issued in CO
Legal business name
COLORADO DEPARTMENT OF CORRECTIONS
Practice address
1410 W 13TH St
Pueblo, CO 81003-1961
Phone
(719) 583-5550
Fax
(719) 583-5525
NPI assigned
Jun 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Authorized official

Name
Mrs. Joanie Shoemaker
Title
Director of Clinical Services
Phone
(719) 226-4535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 19512 CO Primary

Addresses

Primary practice location

1410 W 13TH St
Pueblo, CO 81003-1961

Mailing address

1410 W 13TH St
Pueblo, CO 81003-1961
Phone (719) 583-5550

Other names 1

  • San Carlos Correctional Facility Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1033430442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 W 13TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031961",
            "telephone_number": "719-583-5550",
            "fax_number": "719-583-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 W 13TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031961",
            "telephone_number": "719-583-5550",
            "fax_number": "719-583-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DEPARTMENT OF CORRECTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "JOANIE",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "719-226-4535",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CO",
            "license": "19512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Carlos Correctional Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 21, 2010; 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.