Active NPI
John Rose
- Peer Specialist
- Pueblo, CO
National Provider Identifier
1689112211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 1310 Chinook LN
Pueblo, CO 81001-1851 - Phone
- (719) 545-2746
- Fax
- (719) 584-0110
- NPI assigned
- Feb 2, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
1310 Chinook LN
Pueblo, CO 81001-1851
Mailing address
41 Montebello Rd
Suite 200
Pueblo, CO 81001-1379
Phone (719) 545-2746
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485993600000",
"number": "1689112211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 MONTEBELLO RD",
"address_2": "SUITE 200",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810011379",
"telephone_number": "719-545-2746",
"fax_number": "719-542-9638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 CHINOOK LN",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810011851",
"telephone_number": "719-545-2746",
"fax_number": "719-584-0110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-02",
"last_updated": "2017-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.