NPIMap

Organization Active NPI

Carlotta J. Fendrich, LLC

  • Primary Care Clinic/Center
  • Pueblo, CO
National Provider Identifier
1801206990
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
105868 Issued in CO
Legal business name
CARLOTTA J. FENDRICH, LLC
Practice address
401 Michigan St
Pueblo, CO 81004-2138
Phone
(719) 545-3555
Fax
(719) 545-1517
NPI assigned
Apr 29, 2014
Last updated
May 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Carlotta J Fendrich, NPNPI 1427015767
Title
Nurse Practitioner
Phone
(719) 545-3555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 105868 CO Primary

Addresses

Primary practice location

401 Michigan St
Pueblo, CO 81004-2138

Mailing address

401 Michigan St
Pueblo, CO 81004-2138
Phone (719) 545-3555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1398729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1801206990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MICHIGAN ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042138",
            "telephone_number": "719-545-3555",
            "fax_number": "719-545-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MICHIGAN ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042138",
            "telephone_number": "719-545-3555",
            "fax_number": "719-545-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOTTA J. FENDRICH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "FENDRICH",
        "authorized_official_first_name": "CARLOTTA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "719-545-3555",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "105868",
            "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 May 12, 2014; 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.