Champions Family Medical, PLLC

Primary specialty

Legal MedicineTaxonomy code 173000000X

Legal business name

CHAMPIONS FAMILY MEDICAL, PLLC

Doing business as

Champions Family Medical

Practice address

415 N Grand Ave
Pueblo, CO 81003-3111

Phone

(719) 924-8448

Fax

(719) 924-9382

NPI assigned

Jan 17, 2017

Organization subpart

No

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

Authorized official

Name

Richard B Lane

Title

Practice Manager

Phone

(719) 406-9304

Specialties & licenses 1

Addresses

Other names 1

• Champions Family Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erika J Valdez

  • Family Nurse Practitioner
  • Pueblo, CO
  • NPI 1619510815
  Medicare reassignment NPD

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1700322575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033111",
            "telephone_number": "719-924-8448",
            "fax_number": "719-924-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033111",
            "telephone_number": "719-924-8448",
            "fax_number": "719-924-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPIONS FAMILY MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "719-406-9304"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champions Family Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha Cervantes
• Jorden Cesar, RN
• Claire Chadwell-Bell, RN
• Jennifer Gwen Chambers Simmons, RD
• Terra Chambers, NP
• Ching Han Helen Chan
• Daniel James Chandler, PHARM D
• Megan Chandler
• Kelli Chapman, PA-C
• Mandy Chapman

• Legal Medicine in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Legal Medicine in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.