JKLR Ministries, LLC

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Legal business name

JKLR MINISTRIES, LLC

Practice address

3930 Ridge Dr
# E
Pueblo, CO 81008-1766

Phone

(719) 569-2248

Fax

(719) 595-0085

NPI assigned

Mar 30, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Gerald Leroy Randolph, REV

Title

Director

Phone

(719) 569-2248

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1528200086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 29TH ST",
            "address_2": "3352",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081002",
            "telephone_number": "719-569-2248",
            "fax_number": "719-595-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 RIDGE DR",
            "address_2": "# E",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081766",
            "telephone_number": "719-569-2248",
            "fax_number": "719-595-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JKLR MINISTRIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "719-569-2248",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "REV"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Pastoral",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.