Individual provider Active NPI

Christina M Wooters-Eck, NP

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1659935401
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RXN.0103858-NP Issued in CO
Practice address
300 Colorado Ave
Pueblo, CO 81004-2006
Phone
(719) 543-8718
NPI assigned
Apr 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RXN.0103858-NP CO Primary

Addresses

Primary practice location

300 Colorado Ave
Pueblo, CO 81004-2006

Mailing address

110 E Routt Ave
Pueblo, CO 81004-2117
Phone (719) 543-8718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190621001468 CO Practitioner - Nurse Practitioner 3375877582 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RXN.0103858-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Community Health Center Inc CurrentSince Jun 16, 2019 Accepting new patients
Pueblo Community Health Center Inc CurrentSince Jun 16, 2019 Accepting new patients
Valley-Wide Health Systems, Inc CurrentSince Jun 22, 2020 Accepting new patients
Pueblo Community Health Center Inc Current Accepting new patients
Valley-Wide Health Systems, Inc. CurrentSince Jun 22, 2020 Accepting new patients

Locations

128 Market St
Alamosa, CO 81101
Phone (719) 587-1001

1131 Main St
Alamosa, CO 81101
Phone (719) 589-2562

1012 Belmont Ave
La Junta, CO 81050
Phone (719) 383-5500

110 E Routt Ave
Pueblo, CO 81004
Phone (719) 543-8718

300 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-8718

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1659935401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ROUTT AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042117",
            "telephone_number": "719-543-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042006",
            "telephone_number": "719-543-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTERS-ECK",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-26",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "RXN.0103858-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.