NPIMap

Organization Active NPI

Rock Canyon Healthcare LLC

  • Skilled Nursing Facility
  • Pueblo, CO
National Provider Identifier
1356912794
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ROCK CANYON HEALTHCARE LLC
Practice address
2515 Pitman PL
Pueblo, CO 81004-2633
Phone
(719) 564-0550
Fax
(719) 561-9760
NPI assigned
Jul 7, 2021
Last updated
Aug 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

2515 Pitman PL
Pueblo, CO 81004-2633

Mailing address

2515 Pitman PL
Pueblo, CO 81004-2633
Phone (719) 564-0550

National Provider Directory

National Provider Directory
Tax ID family
Rock Canyon Healthcare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1356912794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 PITMAN PL",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042633",
            "telephone_number": "719-564-0550",
            "fax_number": "719-561-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 PITMAN PL",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042633",
            "telephone_number": "719-564-0550",
            "fax_number": "719-561-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK CANYON HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "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 Aug 29, 2022; 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.