Pueblo Family Medicine, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PUEBLO FAMILY MEDICINE, PC

Practice address

1600 N Grand Ave Ste 310
Pueblo, CO 81003-2729

Phone

(719) 542-0072

Fax

(719) 542-9888

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gregory W Berens, MDNPI 1245295013

Title

President

Phone

(719) 542-0072

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 4

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

• Gregory W Berens, MD

  • Family Medicine Physician
  • Pueblo, CO
  • NPI 1245295013
  Medicare reassignment NPD Authorized official
• Nancy S Chuch, MD

  • Family Medicine Physician
  • Pueblo, CO
  • NPI 1154386365
  Medicare reassignment NPD
• Guy L Kemling, MD

  • Family Medicine Physician
  • Pueblo, CO
  • NPI 1154386795
  Medicare reassignment NPD
• Breanna Danielle Frees, PA-C

  • Physician Assistant
  • Colorado Springs, CO
  • NPI 1134665862
  Medicare reassignment

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1114149986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE STE 310",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032729",
            "telephone_number": "719-542-0072",
            "fax_number": "719-542-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE STE 310",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032729",
            "telephone_number": "719-542-0072",
            "fax_number": "719-542-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "BERENS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-542-0072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pueblo Ear Nose & Throat Specialist
• Pueblo Endodontic Asso LLC
• Pueblo Endoscopy Suites, LLC
• Pueblo ER Physicians LLC
• Pueblo Family Dentistry PLLC
• Pueblo Goodwill Industries Home Care Program
• Pueblo Hearing AIDS LLC
• Pueblo Imaging Center, LLC
• Pueblo Infectious Diseases, PLLC
• Pueblo Massage Therapy LLC

• Primary Care Clinic/Center in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.