Southwest Internal Medicine PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTHWEST INTERNAL MEDICINE PLLC

Practice address

111 N Park St
Cortez, CO 81321-3340

Phone

(970) 564-8730

NPI assigned

Nov 8, 2006

Last updated

Jun 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Erin Henderson, MD

Title

Owner/Ao

Phone

(970) 564-8730

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1083784060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N PARK ST",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813213340",
            "telephone_number": "970-564-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N PARK ST",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813213340",
            "telephone_number": "970-564-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OWNER/AO",
        "authorized_official_telephone_number": "970-564-8730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98950886",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18627269",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "798770",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southwest Health System, Inc. (Southwest Memorial Ambulance)
• Southwest Health System, Inc. (Four Corners Surgical)
• Southwest Health System, Inc. (Southwest Memorial Physicians)
• Southwest Health System, Inc.
• Southwest Health System, Inc. (Southwest Memorial Ambulance)
• Southwest Memorial Home Health
• Southwest Professional Properties, Inc (Vista Mesa Assisted Living)
• Southwest Speech Therapy, LLC
• Speak Easy Speech Therapy LLC
• Balaji Srinivas, MD

• Internal Medicine Physician in Cortez, CO
• Providers in Cortez, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.