NPIMap

Organization Active NPI

Southern Colorado Family Medicine

  • Primary Care Clinic/Center
  • Pueblo, CO
National Provider Identifier
1235424003
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
3209 Issued in CO
Legal business name
SOUTHERN COLORADO FAMILY MEDICINE
Practice address
902 Lakeview Ave
Pueblo, CO 81004-3597
Phone
(719) 557-5855
Fax
(719) 557-5097
NPI assigned
Jun 9, 2011
Last updated
Jun 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Authorized official

Name
Lynn M Strange, M.D
Title
Program Director
Phone
(719) 557-5872

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 3209 CO Primary

Addresses

Primary practice location

902 Lakeview Ave
Pueblo, CO 81004-3597

Mailing address

902 Lakeview Ave
Pueblo, CO 81004-3597

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1235424003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 LAKEVIEW AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 LAKEVIEW AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043597",
            "telephone_number": "719-557-5855",
            "fax_number": "719-557-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COLORADO FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "STRANGE",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "719-557-5872",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "3209",
            "primary": true
        }
    ],
    "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 9, 2011; 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.