NPIMap

Organization Active NPI

Innovative Surgery and Medicine, PC

  • Surgery Physician
  • Pueblo, CO
National Provider Identifier
1154540235
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
INNOVATIVE SURGERY AND MEDICINE, PC
Practice address
1600 W 24TH St
Pueblo, CO 81003-1411
Phone
(719) 546-4947
NPI assigned
Apr 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Authorized official

Name
Rina K Shinn, MDNPI 1164467536
Title
Physician
Phone
(719) 546-4947

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1600 W 24TH St
Pueblo, CO 81003-1411

Mailing address

PO Box 566
Pueblo, CO 81002-0566
Phone (719) 286-5840

Other identifiers 3

IdentifierTypeStateIssuer
VI659839OtherBCBS
DA7417OtherRR MEDICARE
01358845MedicaidCO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1154540235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 566",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810020566",
            "telephone_number": "719-286-5840",
            "fax_number": "719-542-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 24TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031411",
            "telephone_number": "719-546-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SURGERY AND MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "SHINN",
        "authorized_official_first_name": "RINA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "719-546-4947",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "VI659839",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA7417",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01358845",
            "state": "CO"
        }
    ],
    "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 Jan 7, 2008; 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.