Individual provider Active NPI

Gwendolyn Madrid

  • Counselor
  • Pueblo, CO
National Provider Identifier
1033799689
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1591 Taos Rd
Pueblo, CO 81006-1232
Phone
(719) 545-2746
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

1591 Taos Rd
Pueblo, CO 81006-1232

Mailing address

41 Montebello Rd Ste 204
Pueblo, CO 81001-1379

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

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1033799689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MONTEBELLO RD STE 204",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 TAOS RD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810061232",
            "telephone_number": "719-545-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRID",
        "first_name": "GWENDOLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 8, 2021; 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.