NPIMap

Organization Active NPI

Sunflower Mountain Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1336957901
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SUNFLOWER MOUNTAIN MENTAL HEALTH LLC
Practice address
805 Eagleridge Blvd, Ste 140
Pueblo, CO 81008-2354
Phone
(719) 679-5022
Fax
(719) 888-1673
NPI assigned
Dec 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Authorized official

Name
Matthew Blubaugh
Title
Office Manager
Phone
(719) 679-5022

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Clinic/Center 261Q00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

805 Eagleridge Blvd, Ste 140
Pueblo, CO 81008-2354

Mailing address

805 Eagleridge Blvd, Ste 140
Pueblo, CO 81008-2354
Phone (719) 679-5022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250627000820 CO Part B Supplier - Clinic/Group Practice 5294248878 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Pueblo, CO

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Sunflower Mountain Mental Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759449600000",
    "number": "1336957901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 EAGLERIDGE BLVD, STE 140",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082354",
            "telephone_number": "719-679-5022",
            "fax_number": "719-888-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 EAGLERIDGE BLVD, STE 140",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082354",
            "telephone_number": "719-679-5022",
            "fax_number": "719-888-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNFLOWER MOUNTAIN MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-27",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A",
        "authorized_official_last_name": "BLUBAUGH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "719-679-5022"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "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 3, 2025; 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.