SSC Pueblo Belmont Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0874 Issued in CO

Legal business name

SSC PUEBLO BELMONT OPERATING COMPANY LLC

Doing business as

Belmont Lodge Health Care Center

Practice address

1601 Constitution Rd
Pueblo, CO 81001-2132

Phone

(719) 562-7200

NPI assigned

Apr 2, 2007

Last updated

Nov 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Belmont Lodge Health Care Center Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1255451142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415161",
            "telephone_number": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CONSTITUTION RD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810012132",
            "telephone_number": "719-562-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC PUEBLO BELMONT OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "SANTORO",
        "authorized_official_first_name": "KELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SR DIRECTOR AR",
        "authorized_official_telephone_number": "832-467-5728"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "0874",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "CO",
            "license": "0874",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11434317",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13479814",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMDR eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Belmont Lodge Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Belmont Lodge Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenna Sprong
• Louise A Spugnardi, NP
• Stevie Nichole Spurlin, PA
• Havilah R. Spurlock, FNP-C
• Lynn Squier
• SSC Pueblo Operating Company LLC (Minnequa Medicenter)
• SSC Pueblo Operating Company LLC (Minnequa Medicenter)
• Lesli St. John, LPC, LAC
• John Stachler, M.D.
• Nathan Stacy, FNP-C

• Skilled Nursing Facility in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.