Individual provider Active NPI

Justin Williams, DO

  • Obstetrics & Gynecology Physician
  • Pueblo, CO
National Provider Identifier
1477085462
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DR.0074466 Issued in CO
Practice address
1501 Court St
Pueblo, CO 81003-2720
Phone
(719) 543-6755
Fax
(719) 583-2236
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DR.0074466 CO Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1501 Court St
Pueblo, CO 81003-2720

Mailing address

2695 Rocky Mountain Ave
Loveland, CO 80538-8702
Phone (970) 624-2403

Other practice location 1

4010 Jerry Murphy Rd
Pueblo, CO 81001-1045
Phone (719) 562-2021

Other practice location 2

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

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250219001851 CO Practitioner - Obstetrics/Gynecology 7618241837

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0074466COMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Medical Center, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1477085462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388702",
            "telephone_number": "970-624-2403",
            "fax_number": "970-490-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 COURT ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032720",
            "telephone_number": "719-543-6755",
            "fax_number": "719-583-2236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4010 Jerry Murphy Rd",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810011045",
            "country_code": "US",
            "telephone_number": "719-562-2021",
            "fax_number": "719-583-2236",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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",
            "fax_number": "719-543-1041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JUSTIN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "DR.0074466",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.