NPIMap

Organization Active NPI

Delta Waves of Woodland Park Inc

Doing business as Delta Waves of Pueblo

  • Sleep Disorder Diagnostic Clinic/Center
  • Pueblo, CO
National Provider Identifier
1679892475
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
DELTA WAVES OF WOODLAND PARK INC
Doing business as
Delta Waves of Pueblo
Practice address
3921 Outlook Blvd
Ste D
Pueblo, CO 81008-1580
Phone
(719) 583-9283
Fax
(719) 583-9285
NPI assigned
May 19, 2010
Last updated
May 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Authorized official

Name
Randall Lowell Anderson
Title
President
Phone
(719) 262-9283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X Primary

Addresses

Primary practice location

3921 Outlook Blvd
Ste D
Pueblo, CO 81008-1580

Mailing address

5835 Lehman Dr
Ste. 101
Colorado Springs, CO 80918-3408
Phone (719) 262-9283

Other names 1

  • Delta Waves of Pueblo Doing business as

National Provider Directory

National Provider Directory

Locations

3921 Outlook Blvd
Ste D
Pueblo, CO 81008
Phone (719) 583-9283

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274227200000",
    "number": "1679892475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5835 LEHMAN DR",
            "address_2": "STE. 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183408",
            "telephone_number": "719-262-9283",
            "fax_number": "719-262-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 OUTLOOK BLVD",
            "address_2": "STE D",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081580",
            "telephone_number": "719-583-9283",
            "fax_number": "719-583-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA WAVES OF WOODLAND PARK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-19",
        "last_updated": "2010-05-19",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "LOWELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-262-9283"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Waves of Pueblo",
            "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 May 19, 2010; 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.