NPIMap

Organization Active NPI

Pueblo Ankle and Foot Care, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Pueblo, CO
National Provider Identifier
1790999035
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
665 Issued in CO
Legal business name
PUEBLO ANKLE AND FOOT CARE, PLLC
Practice address
1619 N Greenwood St
#300
Pueblo, CO 81003-2657
Phone
(719) 543-2476
Fax
(719) 543-2479
NPI assigned
May 9, 2007
Last updated
Apr 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Jessica Marie Helvey
Title
Billing & Credentialing Lead
Phone
(719) 544-7170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 665 CO Primary

Addresses

Primary practice location

1619 N Greenwood St
#300
Pueblo, CO 81003-2657

Mailing address

1619 N Greenwood St
#300
Pueblo, CO 81003-2657
Phone (719) 543-2476

Other practice location 1

323 S Purcell Blvd
Pueblo West, CO 81007-5045
Phone (719) 543-2476

Other identifiers 3

IdentifierTypeStateIssuer
12630861MedicaidCO
DG0622OtherCORAILROAD MEDICARE
PUPU665OtherCOBC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070713000536 CO Part B Supplier - Clinic/Group Practice 0749380103 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Pueblo, CO; Pueblo West, CO
O20100930030352 CO DME Supplier - Physician - Podiatry 0749380103 Practice locations: Pueblo, CO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1790999035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 N GREENWOOD ST",
            "address_2": "#300",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032657",
            "telephone_number": "719-543-2476",
            "fax_number": "719-543-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 N GREENWOOD ST",
            "address_2": "#300",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032657",
            "telephone_number": "719-543-2476",
            "fax_number": "719-543-2479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 S Purcell Blvd",
            "address_purpose": "LOCATION",
            "city": "Pueblo West",
            "state": "CO",
            "postal_code": "810075045",
            "country_code": "US",
            "telephone_number": "719-543-2476",
            "fax_number": "719-543-2479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PUEBLO ANKLE AND FOOT CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "HELVEY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BILLING & CREDENTIALING LEAD",
        "authorized_official_telephone_number": "719-544-7170"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12630861",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG0622",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "PUPU665",
            "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 3, 2023; 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.