Individual provider Active NPI

John Ryan Vialpando, BS

  • Substance Abuse Rehabilitation Facility
  • Pueblo, CO
National Provider Identifier
1770819393
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
84 0810723 Issued in CO
Practice address
3470 Baltimore Ave
Pueblo, CO 81008-1520
Phone
(719) 561-9850
Fax
(719) 545-4097
NPI assigned
Nov 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 84 0810723 CO Primary

Addresses

Primary practice location

3470 Baltimore Ave
Pueblo, CO 81008-1520

Mailing address

3470 Baltimore Ave
Pueblo, CO 81008-1520
Phone (719) 561-9850

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
84 0810723COMDSubstance Abuse Rehabilitation Facility

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1770819393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3470 BALTIMORE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081520",
            "telephone_number": "719-561-9850",
            "fax_number": "719-545-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3470 BALTIMORE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081520",
            "telephone_number": "719-561-9850",
            "fax_number": "719-545-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIALPANDO",
        "first_name": "JOHN",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-02",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CO",
            "license": "84 0810723",
            "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 Nov 2, 2009; 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.