NPIMap

Individual provider Active NPI

Rosalyn Walker, FNP-C

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1366112880
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0996937-NP Issued in CO
Practice address
3676 Parker Blvd
Pueblo, CO 81008-2212
Phone
(719) 553-1804
Fax
(833) 916-2047
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0996937-NP CO Primary

Addresses

Primary practice location

3676 Parker Blvd
Pueblo, CO 81008-2212

Mailing address

PO Box 9000
Pueblo, CO 81008-9000
Phone (719) 553-2200

Other practice location 1

1600 N Grand Ave Ste 400
Pueblo, CO 81003-2760
Phone (719) 585-2500

Other names 1

  • Rosalyn Grieder Former name

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
I20211006001571 CO Practitioner - Nurse Practitioner 2264830215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Colorado Clinic PCGroup PAC ID 4284524067, 36 clinicians

Practice addresses (Care Compare)

3676 Parker Blvd
Suite 290
Pueblo, CO 81008-2214
Phone (719) 553-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Clinic PC CurrentSince Jun 12, 2024 Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients

Locations

2403 Santa Fe Dr
Ste 7
Pueblo, CO 81006
Phone (719) 404-1489

3676 Parker Blvd
Ste 220
Pueblo, CO 81008

3676 Parker Blvd
Ste 370
Pueblo, CO 81008
Phone (719) 553-2209

3676 Parker Blvd
Pueblo, CO 81008
Phone (719) 253-7000

3676 Parker Blvd
Ste 290
Pueblo, CO 81008
Phone (719) 553-2200

109 S Burlington Dr
Pueblo West, CO 81007
Phone (719) 766-9000

Interoperability endpoints

  • Direct secure messaging: rosalyn.walker.1@21306.direct.athenahealth.com

Organizations & group practices 2

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 10

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": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1366112880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9000",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810089000",
            "telephone_number": "719-553-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "719-553-1804",
            "fax_number": "833-916-2047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N Grand Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810032760",
            "country_code": "US",
            "telephone_number": "719-585-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ROSALYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0996937-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSALYN",
            "last_name": "GRIEDER",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.