NPIMap

Individual provider Active NPI

Jamie M. Pollock, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Pueblo, CO
National Provider Identifier
1356470876
Registry record updated Jul 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
44011 Issued in CO
Practice address
509 Colorado Ave Ste C
Pueblo, CO 81004-2008
Phone
(719) 696-9828
Fax
(719) 696-9862
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44011 CO
Addiction Medicine (Family Medicine) Physician 207QA0401X 44011 CO Primary

Addresses

Primary practice location

509 Colorado Ave Ste C
Pueblo, CO 81004-2008

Mailing address

509 Colorado Ave
Suite C
Pueblo, CO 81004-2008
Phone (719) 696-9828

Other identifiers 1

IdentifierTypeStateIssuer
25833375MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070808000351 CO Practitioner - Family PracticePractitioner - Addiction Medicine 0547351314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Addiction Medicine
Education
University of Colorado School of Medicine, Denver, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

509 Colorado Ave
Suite C
Pueblo, CO 81004-2008
Phone (719) 696-9828

Hospital & facility affiliations

  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jandyco, LLC Addiction Medicine CurrentSince Dec 1, 2012 Accepting new patients
Inpatient Consultants of Colorado PC Family Medicine CurrentSince Sep 14, 2011 Accepting new patients
Inpatient Consultants of Colorado PC Family Medicine CurrentSince Sep 14, 2011 Accepting new patients
Star Rehab Therapy LLC Past Accepting new patients
Pikes Peak Physical Medicine, P.C. Past Accepting new patients
Inpatient Consultants of Colorado, PC Family Medicine Past Accepting new patients
Star Rehab Prof Physicians, LLC Family Medicine Past Accepting new patients

Locations

2000 S Colorado Blvd
Ste 420
Denver, CO 80222
Phone (720) 524-1550

509 Colorado Ave
Ste C
Pueblo, CO 81004
Phone (719) 591-0011

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1356470876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 COLORADO AVE",
            "address_2": "SUITE C",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042008",
            "telephone_number": "719-696-9828",
            "fax_number": "719-696-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 COLORADO AVE STE C",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042008",
            "telephone_number": "719-696-9828",
            "fax_number": "719-696-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "JAMIE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "44011",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CO",
            "license": "44011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25833375",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.