Prosthetic & Orthotic Group - Southern Colorado, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROSTHETIC & ORTHOTIC GROUP - SOUTHERN COLORADO, LLC

Practice address

1310 Fortino Blvd Ste B
Pueblo, CO 81008-2076

Phone

(719) 542-1313

Fax

(719) 542-9140

NPI assigned

Feb 9, 2017

Organization subpart

Yes

Parent organization

HANGER INCAs reported in NPPES

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

Authorized official

Name

Grace Angeline

Title

Reg Comp Analyst II

Phone

(714) 961-2102

Specialties & licenses 2

Addresses

Networks

• devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a

Practitioners 3

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

• Sara Vengrove, DPT

  • Physical Therapist
  • Denver, CO
  • NPI 1619379823
  NPD
• Todd Bush

  • Prosthetist
  • Pueblo, CO
  • NPI 1144829219
  NPD (past)
• Elizabeth Bush, CPO

  • Orthotist
  • Richmond, VA
  • NPI 1366041428
  NPD (past)

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1053859009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650846",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 FORTINO BLVD STE B",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082076",
            "telephone_number": "719-542-1313",
            "fax_number": "719-542-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC & ORTHOTIC GROUP - SOUTHERN COLORADO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HANGER INC",
        "enumeration_date": "2017-02-09",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A",
        "authorized_official_last_name": "ANGELINE",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "REG COMP ANALYST II",
        "authorized_official_telephone_number": "714-961-2102"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Rae Proctor, M.D.
• Professional Associates of Surgical Services Inc.
• Professional Home Health Care, Inc.
• Professional Home Health Care, Inc.
• Jenny Proffer
• Lisa Provenza
• Kylee Provost, DNP
• Prudencio a Cosyleon
• Alexandra Prutch
• Vernalisa Prutch

• Prosthetic/Orthotic Supplier in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Prosthetic/Orthotic Supplier in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; 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.