Pueblo Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PUEBLO CARE LLC

Practice address

109 E 17TH St Ste 6178
Cheyenne, WY 82001-4543

Phone

(720) 761-1362

NPI assigned

Mar 24, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Mario Rafael Anglada Cortes

Title

Ceo

Phone

(720) 761-1362

Specialties & licenses 3

Addresses

Other names 1

• Pueblo Care Doing business as

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1699576587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E 17TH ST STE 6178",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014543",
            "telephone_number": "720-761-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E 17TH ST STE 6178",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014543",
            "telephone_number": "720-761-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "ANGLADA CORTES",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "RAFAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-761-1362",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pueblo Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pueblo Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Provencio
• Chris E Pry
• Mary Jane Prysock, RN, BSN
• Psychological and Consulting Services, P.C.
• Kerri Puckett
• Pueblo Care Wy LLC
• Kacie R Pugel, PT, DPT
• Take George Pullos, M.D.
• Kimberly S Purifoy, FNP-C
• Cheryl Pushcar

• Internal Medicine Physician in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Internal Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.