Boondocs Medical Services, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BOONDOCS MEDICAL SERVICES, LLC

Practice address

1021 N Market PLZ
Pueblo West, CO 81007-1531

Phone

(719) 470-8706

NPI assigned

Oct 9, 2020

Organization subpart

No

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

Authorized official

Name

Sheryl Belanger, MD

Title

Owner

Phone

(719) 470-8706

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603584000000",
    "number": "1144828401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MARKET PLZ",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810071531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N MARKET PLZ",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810071531",
            "telephone_number": "719-470-8706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONDOCS MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A",
        "authorized_official_last_name": "BELANGER",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-470-8706",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Scott Bethel, RPH
• Shannon Belle Bethel, RPH
• Heather Jeanne Bever, MA, CCC-SLP
• Mark Blaskovich, D.M.D.
• Jessica Bollman, MS, BCBA
• Braden Partners LP (Pacific Pulmonary Services)
• Daphne Dawn Bradley, FNP
• Braincare LLC
• Candace Brandenburg, LPC
• Patricia Marie Brewer, PT, DPT

• Family Medicine Physician in Pueblo West, CO
• Providers in Pueblo West, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; 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.