NPIMap

Organization Active NPI

Parkwest Imaging, L.L.C

  • Diagnostic Radiology Physician
  • Pueblo, CO
National Provider Identifier
1790730810
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PARKWEST IMAGING, L.L.C
Practice address
3676 Parker Blvd Suite 165
Pueblo, CO 81008-2212
Phone
(719) 595-7600
Fax
(719) 595-7661
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Authorized official

Name
Cookie Henderson, R.T.
Title
Office Manager
Phone
(719) 542-2167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3676 Parker Blvd Suite 165
Pueblo, CO 81008-2212

Mailing address

Dept 1391
Denver, CO 80291-1391
Phone (719) 542-2167

Other identifiers 1

IdentifierTypeStateIssuer
91634237MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000949 CO Part B Supplier - Clinic/Group Practice 3173415247 Receives reassigned benefits from 11 practitioners
Practice locations: Pueblo, CO

National Provider Directory

National Provider Directory

Locations

Dept 1391
Denver, CO 80291

3676 Parker Blvd
Ste 165
Pueblo, CO 81008
Phone (719) 253-7040

3676 Parker Blvd
Pueblo, CO 81008
Phone (719) 253-7000

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1790730810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 1391",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802911391",
            "telephone_number": "719-542-2167",
            "fax_number": "719-542-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD SUITE 165",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "719-595-7600",
            "fax_number": "719-595-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWEST IMAGING, L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "COOKIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "719-542-2167",
        "authorized_official_credential": "R.T."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91634237",
            "state": "CO"
        }
    ],
    "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 Apr 11, 2012; 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.