NPIMap

Organization Active NPI

Rural Physicians Group - Pannu PLLC

  • Hospitalist Physician
  • Canon City, CO
National Provider Identifier
1336720580
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
RURAL PHYSICIANS GROUP - PANNU PLLC
Practice address
1338 Phay Ave
Canon City, CO 81212-2311
Phone
(303) 390-1924
NPI assigned
Apr 19, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Sukhbir S Pannu
Title
Ceo/Owner
Phone
(702) 933-3266

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20141017001015 CO Part B Supplier - Clinic/Group Practice 0345467486 Receives reassigned benefits from 71 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sterling, CO; Canon City, CO; Rifle, CO; Pueblo, CO; Leadville, CO; Delta, CO; Cortez, CO; Colorado Springs, CO…

National Provider Directory

National Provider Directory
Tax ID family
Rural Physicians Group - Pannu PLLC (8 organizations share this tax ID)

Locations

5575 Dtc Pkwy
Ste 225
Greenwood Village, CO 80111

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1338 Phay Ave
Canon City, CO 81212-2311

Mailing address

5575 DTC Pkwy
Greenwood Village, CO 80111-3008

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
9000160748MedicaidCO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 21, 2023.

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1336720580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 DTC PKWY",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 PHAY AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122311",
            "telephone_number": "303-390-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL PHYSICIANS GROUP - PANNU PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "PANNU",
        "authorized_official_first_name": "SUKHBIR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "702-933-3266"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000160748",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.