NPIMap

Organization Active NPI

Pueblo Care and Rehab

  • Skilled Nursing Facility
  • Pueblo, CO
National Provider Identifier
1225373418
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1401044 Issued in CO
Legal business name
PUEBLO CARE AND REHAB
Practice address
2611 Jones Ave
Pueblo, CO 81004-2650
Phone
(719) 544-4408
Fax
(719) 566-1960
NPI assigned
Nov 29, 2012
Last updated
Jun 22, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Authorized official

Name
Karen Wilson Wilson, CERTIFICATION
Title
Certified OT Assistant/Cota
Phone
(719) 544-4408

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1401044 CO Primary
Respite Care 385H00000X 1401044 CO

Addresses

Primary practice location

2611 Jones Ave
Pueblo, CO 81004-2650

Mailing address

2611 Jones Ave
Pueblo, CO 81004-2650
Phone (719) 544-4408

National Provider Directory

National Provider Directory
Tax ID family
Peak Medical Colorado No 2 Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498089600000",
    "number": "1225373418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 JONES AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042650",
            "telephone_number": "719-544-4408",
            "fax_number": "719-566-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 JONES AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042650",
            "telephone_number": "719-544-4408",
            "fax_number": "719-566-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO CARE AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-29",
        "last_updated": "2017-06-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KAREN WILSON",
        "authorized_official_title_or_position": "CERTIFIED OT ASSISTANT/COTA",
        "authorized_official_telephone_number": "719-544-4408",
        "authorized_official_credential": "CERTIFICATION"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "1401044",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "CO",
            "license": "1401044",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jun 22, 2017; 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.