NPIMap

Organization Active NPI

CK Surgical LLC

  • Plastic and Reconstructive Surgery Physician
  • Pueblo, CO
National Provider Identifier
1285652966
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
CK SURGICAL LLC
Practice address
650 Dittmer Avenue
Pueblo, CO 81005-1212
Phone
(719) 565-1000
Fax
(719) 565-1111
NPI assigned
Jul 18, 2006
Last updated
Oct 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Charles Willis Kessler, MD PANPI 1013949288
Title
Owner
Phone
(719) 565-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0105X
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

650 Dittmer Avenue
Pueblo, CO 81005-1212

Mailing address

650 Dittmer Avenue
Pueblo, CO 81005-1212
Phone (719) 565-1000

Other identifiers 1

IdentifierTypeStateIssuer
KE32539OtherCOBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1285652966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 DITTMER AVENUE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810051212",
            "telephone_number": "719-565-1000",
            "fax_number": "719-565-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 DITTMER AVENUE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810051212",
            "telephone_number": "719-565-1000",
            "fax_number": "719-565-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CK SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "KESSLER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WILLIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-565-1000",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "KE32539",
            "state": "CO"
        }
    ],
    "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 Oct 25, 2007; 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.