NPIMap

Organization Active NPI

CS Cardiology Newco LLC

Doing business as Southern Colorado Heart and Vascular

  • Cardiovascular Disease Physician
  • Pueblo West, CO
National Provider Identifier
1518748433
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CS CARDIOLOGY NEWCO LLC
Doing business as
Southern Colorado Heart and Vascular
Practice address
904 Hailey LN Unit CD
Pueblo West, CO 81007-4455
Phone
(719) 960-0363
NPI assigned
Oct 6, 2023
Last updated
Feb 17, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CS CARDIOLOGY NEWCO LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name
Erin Petrie
Title
VP of RCM
Phone
(708) 498-4493

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary
Vascular Surgery Physician 2086S0129X

Addresses

Primary practice location

904 Hailey LN Unit CD
Pueblo West, CO 81007-4455

Mailing address

904 Hailey LN
Unit C & D
Pueblo West, CO 81007

Other names 1

  • Southern Colorado Heart and Vascular Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230901000086 CO Part B Supplier - Clinic/Group Practice 2365805736 Receives reassigned benefits from 57 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Canon City, CO; Colorado Springs, CO; Durango, CO; Pueblo West, CO

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
CS Cardiology Newco LLC9 organizations share this tax ID, including this one
Part of
CS Cardiology Newco LLC

Other organizations with this tax ID 8

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

Locations

904 E Hailey Ln
Unit Cd
Pueblo West, CO 81007

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1518748433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 HAILEY LN",
            "address_2": "UNIT C & D",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "81007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 HAILEY LN UNIT CD",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810074455",
            "telephone_number": "719-960-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CS CARDIOLOGY NEWCO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CS CARDIOLOGY NEWCO LLC",
        "enumeration_date": "2023-10-06",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "PETRIE",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "VP OF RCM",
        "authorized_official_telephone_number": "708-498-4493"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Colorado Heart and Vascular",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo West, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.