Active NPI
Peak Medical Colorado No. 2, LLC
Doing business as Pueblo Care and Rehabilitation Center
- Skilled Nursing Facility
- Pueblo, CO
National Provider Identifier
1598719312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0485
- Legal business name
- PEAK MEDICAL COLORADO NO. 2, LLC
- Doing business as
- Pueblo Care and Rehabilitation Center
Pueblo Center - Practice address
- 2611 Jones Ave
Pueblo, CO 81004-2650 - Phone
- (719) 564-1735
- Fax
- (719) 564-1501
- NPI assigned
- May 19, 2006
- Last updated
- Jul 8, 2021
- Organization subpart
- Yes
- Parent organization
- SUNBRIDGE HEALTHCARE LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael T. Berg
- Title
- VP Assistant Secretary
- Phone
- (505) 468-4742
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0485 | CO | Primary |
Addresses
Primary practice location
2611 Jones Ave
Pueblo, CO 81004-2650
Mailing address
101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60052279 | Medicaid | CO |
Other names 2
- Pueblo Care and Rehabilitation Center
- Pueblo Center
National Provider Directory
National Provider Directory- Part of
- Sunrise HLTH Care Corp
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Columbia Crest Center
- Skilled Nursing Facility
- Moses Lake, WA
- NPI 1982651758
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1625702400000",
"number": "1598719312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SUN AVE NE",
"address_2": "COMPLIANCE DEPARTMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094373",
"telephone_number": "505-468-5604",
"fax_number": "505-468-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2611 JONES AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810042650",
"telephone_number": "719-564-1735",
"fax_number": "719-564-1501"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEAK MEDICAL COLORADO NO. 2, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE LLC",
"enumeration_date": "2006-05-19",
"last_updated": "2021-07-08",
"certification_date": "2021-07-08",
"status": "A",
"authorized_official_last_name": "BERG",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "T.",
"authorized_official_title_or_position": "VP ASSISTANT SECRETARY",
"authorized_official_telephone_number": "505-468-4742"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CO",
"license": "0485",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60052279",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pueblo Care and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Pueblo Care and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Pueblo Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.