Individual provider Active NPI

Emily Fillmore

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1407265291
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09926697 Issued in CO
Practice address
1310 Chinook LN
Pueblo, CO 81001-1851
Phone
(719) 545-2746
Fax
(719) 584-0110
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X CSW.09926697 CO Primary

Addresses

Primary practice location

1310 Chinook LN
Pueblo, CO 81001-1851

Mailing address

41 Montebello Rd
Suite 200
Pueblo, CO 81001-1379
Phone (719) 545-2746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200716000911 CO Practitioner - Clinical Social Worker 9335563907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health SolutionsGroup PAC ID 0143110668, 39 clinicians

Practice addresses (Care Compare)

1310 Chinook LN
Pueblo, CO 81001-1851
Phone (719) 545-2746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Health Solutions CurrentSince Jun 3, 2020 Accepting new patients
Health Solutions CurrentSince Jun 3, 2020 Accepting new patients
Health Solutions Current Accepting new patients
Health Solutions Past Accepting new patients

Locations

41 Montebello Rd
Ste 100
Pueblo, CO 81001

41 Montebello Rd
Ste 204
Pueblo, CO 81001
Phone (719) 423-1341

1302 Chinook Ln
Pueblo, CO 81001

2003 E 4th St
Pueblo, CO 81001
Phone (719) 544-6373

1304 Chinook Ln
Pueblo, CO 81001
Phone (719) 562-3222

1012 W Abriendo Ave
Pueblo, CO 81004
Phone (719) 583-2207

1310 Chinook Ln
Pueblo, CO 81001

41 Montebello Rd
Ste 200
Pueblo, CO 81001
Phone (719) 545-1575

41 Montebello Rd
Ste 104
Pueblo, CO 81001

41 Montebello Rd
Ste 116
Pueblo, CO 81001
Phone (719) 423-1500

910 E Main St
Trinidad, CO 81082
Phone (719) 631-3370

417 S Indiana Ave
Trinidad, CO 81082
Phone (719) 846-4416

926 Russell Ave
Walsenburg, CO 81089
Phone (719) 738-2386

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1407265291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MONTEBELLO RD",
            "address_2": "SUITE 200",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011379",
            "telephone_number": "719-545-2746",
            "fax_number": "719-542-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 CHINOOK LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011851",
            "telephone_number": "719-545-2746",
            "fax_number": "719-584-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.