Pueblo Neuroscience LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PUEBLO NEUROSCIENCE LLC

Practice address

1925 E Orman Ave
Suite G32
Pueblo, CO 81004-3537

Phone

(719) 564-0883

Fax

(719) 564-0861

NPI assigned

Jun 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sumant Rawat, M.D.

Title

Owner

Phone

(719) 564-0883

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pueblo Neurology Doing business as

Locations

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1497792816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 E ORMAN AVE",
            "address_2": "SUITE G32",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043537",
            "telephone_number": "719-564-0883",
            "fax_number": "719-564-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 E ORMAN AVE",
            "address_2": "SUITE G32",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043537",
            "telephone_number": "719-564-0883",
            "fax_number": "719-564-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO NEUROSCIENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "RAWAT",
        "authorized_official_first_name": "SUMANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-564-0883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14355779",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pueblo Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.