NPIMap

Organization Active NPI

Affordable Health Clinic, LLC

  • Clinic/Center
  • Pueblo, CO
National Provider Identifier
1306184056
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
81123 Issued in CO
Legal business name
AFFORDABLE HEALTH CLINIC, LLC
Practice address
900 Indiana Ave St D
Pueblo, CO 81004-8100
Phone
(719) 924-9021
Fax
(719) 924-9166
NPI assigned
Jan 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Mrs. Dawn Leslie Evert, NP-C
Title
Owner
Phone
(719) 924-9021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 81123 CO Primary

Addresses

Primary practice location

900 Indiana Ave St D
Pueblo, CO 81004-8100

Mailing address

900 Indiana Ave St D
Pueblo, CO 81004-7503
Phone (719) 924-9021

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1306184056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 INDIANA AVE ST D",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810047503",
            "telephone_number": "719-924-9021",
            "fax_number": "719-924-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 INDIANA AVE ST D",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810048100",
            "telephone_number": "719-924-9021",
            "fax_number": "719-924-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-30",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "EVERT",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-924-9021",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CO",
            "license": "81123",
            "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 Oct 6, 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.