Hope Internal Medicine of Pueblo, Prof LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

48210 Issued in CO

Legal business name

HOPE INTERNAL MEDICINE OF PUEBLO, PROF LLC

Practice address

728 N Elizabeth St
Pueblo, CO 81003-2335

Phone

(719) 543-9158

Fax

(719) 544-1958

NPI assigned

Mar 6, 2012

Organization subpart

No

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

Authorized official

Name

Opeymi A Banjoko, MD

Title

Owner

Phone

(719) 543-9158

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Opeyemi A Banjoko, MD

  • Internal Medicine Physician
  • Pueblo, CO
  • NPI 1134373020
  Medicare reassignment NPD
• Craig Alan Drew, NP-C

  • Family Nurse Practitioner
  • Pueblo, CO
  • NPI 1316268972
  NPD (past)

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1184998387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 N ELIZABETH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032335",
            "telephone_number": "719-543-9158",
            "fax_number": "719-544-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N ELIZABETH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032335",
            "telephone_number": "719-543-9158",
            "fax_number": "719-544-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE INTERNAL MEDICINE OF PUEBLO, PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-06",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "BANJOKO",
        "authorized_official_first_name": "OPEYMI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-543-9158",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "48210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Haven Therapy PLLC
• Hope Haven Therapy PLLC
• Hope Haven Therapy PLLC
• Hope Haven Therapy PLLC
• Hope Haven Therapy PLLC
• Hope Recovery Center LLC
• Hope Thru Hooves
• Cherokee L Hope, LMT
• Tammela M Hopkins
• Tammy Katherine Hopman, LCSW

• Internal Medicine Physician in Pueblo, CO
• Providers in Pueblo, 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 Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.