NPIMap

Organization Active NPI

Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • La Junta, CO
National Provider Identifier
1790608776
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PUEBLO COMMUNITY HEALTH CENTER INC
Practice address
1100 Carson Avenue
Ste Specialty Clinic
La Junta, CO 81050
Phone
(719) 543-8711
Fax
(719) 543-0171
NPI assigned
Aug 4, 2026
Organization subpart
Yes
Parent organization
PUEBLO COMMUNITY HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Phillip L Davis
Title
Chief Financial Officer
Phone
(719) 543-8718

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1100 Carson Avenue
Ste Specialty Clinic
La Junta, CO 81050

Mailing address

110 E Routt Ave
Pueblo, CO 81004-2117
Phone (719) 543-8711

National Provider Directory

National Provider Directory
Tax ID family
Pueblo Community Health17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

1100 Carson Ave
Ste Specialty
La Junta, CO 81050

NPI Registry JSON

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

{
    "created_epoch": "1785801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1790608776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ROUTT AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042117",
            "telephone_number": "719-543-8711",
            "fax_number": "719-585-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CARSON AVENUE",
            "address_2": "STE SPECIALTY CLINIC",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "81050",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUEBLO COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2026-08-04",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "719-543-8718"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Junta, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.