Obstetrix Medical Group of Colorado, PC

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

Legal business name

OBSTETRIX MEDICAL GROUP OF COLORADO, PC

Doing business as

Rocky Mountain Pediatric Cardiology

Practice address

4021 Avenue B
Scottsbluff, NE 69361-4602

Phone

(308) 635-3711

NPI assigned

Jan 11, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Richard P Porreco, MD

Title

President

Phone

(954) 384-0175

Specialties & licenses 1

Addresses

Other names 1

• Rocky Mountain Pediatric Cardiology Doing business as

Tax ID family

Obstetrix Medical Group of Colorado PC102 organizations share this tax ID, including this one

Locations

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1235728791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4722 N 24TH ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164838",
            "telephone_number": "877-737-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 AVENUE B",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614602",
            "telephone_number": "308-635-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRIX MEDICAL GROUP OF COLORADO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "PORRECO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-384-0175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocky Mountain Pediatric Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Cardiology Physician in Scottsbluff, NE
• Providers in Scottsbluff, NE by specialty
• Pediatric Cardiology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.