Paul Glenn Merchant Jr., M.D.

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

0053139 Issued in CO

Practice address

45825 E State Highway 96
Pueblo, CO 81006-9330

Phone

(719) 549-5483

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pueblo Chemical Agent-Destruction Pilot Plant

  • Occupational Medicine Clinic/Center
  • Pueblo, CO
  • NPI 1356088595
  NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1609896299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4737 BELLA COLLINA CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809067510",
            "telephone_number": "719-337-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45825 E STATE HIGHWAY 96",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810069330",
            "telephone_number": "719-549-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "PAUL",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "NC",
            "license": "37900",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CO",
            "license": "0053139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica Lynn Mendoza, MA, LPC
• Katie Mendoza
• Megan Elisabeth Mensing, MSPT
• Mentally Ill Kids in Distress
• John Zachary Merchant
• Nathaniel S. Merriott
• Mesa Pharmacy of Pueblo, Inc.
• Dillon Meserve
• Mohammad Reza Mesmarian, DDS
• Savanna Rose Messer

• Preventive Medicine/Occupational Environmental Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.