SSC Pueblo Operating Company LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

License

0004 Issued in CO

Legal business name

SSC PUEBLO OPERATING COMPANY LLC

Doing business as

Minnequa Medicenter

Practice address

2701 California St
Pueblo, CO 81004-3869

Phone

(719) 561-1300

NPI assigned

May 21, 2018

Organization subpart

Yes

Parent organization

SSC PUEBLO OPERATING COMPANY LLCAs reported in NPPES

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

Authorized official

Name

Ken Pitts

Title

Director Reimbursement

Phone

(832) 467-6793

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Minnequa Medicenter Doing business as

Part of

SSC Pueblo Operating Company LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• SSC Pueblo Operating Company LLC

  dba Minnequa Medicenter

  • Skilled Nursing Facility
  • Pueblo, CO
  • NPI 1881715910
  NPPES parent name

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526860800000",
    "number": "1235620840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415162",
            "telephone_number": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CALIFORNIA ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043869",
            "telephone_number": "719-561-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC PUEBLO OPERATING COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSC PUEBLO OPERATING COMPANY LLC",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A",
        "authorized_official_last_name": "PITTS",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "DIRECTOR REIMBURSEMENT",
        "authorized_official_telephone_number": "832-467-6793"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "CO",
            "license": "0004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000160668",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minnequa Medicenter",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Minnequa Medicenter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Louise A Spugnardi, NP
• Stevie Nichole Spurlin, PA
• Havilah R. Spurlock, FNP-C
• Lynn Squier
• SSC Pueblo Belmont Operating Company LLC (Belmont Lodge Health Care Center)
• SSC Pueblo Operating Company LLC (Minnequa Medicenter)
• Lesli St. John, LPC, LAC
• John Stachler, M.D.
• Nathan Stacy, FNP-C
• Lucinei Geraldo Stadnik, MD

• Respite Care in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Respite Care in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.