Active NPI
Michelle Dennison, AGACNP-BC; FNP-BC
- Nurse Practitioner
- Pueblo, CO
National Provider Identifier
1699654871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APN.1001674-NP
- Practice address
- 3676 Parker Blvd Ste 290
Pueblo, CO 81008-2214 - Phone
- (719) 553-2201
- NPI assigned
- Sep 1, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APN.1001674-NP | CO | Primary |
Addresses
Primary practice location
3676 Parker Blvd Ste 290
Pueblo, CO 81008-2214
Mailing address
689 E Longsdale Dr
Pueblo West, CO 81007-6578
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
689 E Longsdale Dr
Pueblo West, CO 81007-6578
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN.1001674-NP | CO | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Colorado Clinic PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- Pueblo, CO
- NPI 1285613554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772064000000",
"number": "1699654871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "689 E LONGSDALE DR",
"city": "PUEBLO WEST",
"state": "CO",
"postal_code": "810076578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3676 PARKER BLVD STE 290",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810082214",
"telephone_number": "719-553-2201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNISON",
"first_name": "MICHELLE",
"credential": "AGACNP-BC; FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-01",
"last_updated": "2026-02-26",
"certification_date": "2026-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "APN.1001674-NP",
"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 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.