Individual provider Active NPI

Kari Ann Stenerson Eckman, D.O.

  • Emergency Medicine Physician
  • Pueblo, CO
National Provider Identifier
1811106354
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
50570 Issued in CO
Practice address
400 W 16TH St
Pueblo, CO 81003-2745
Phone
(719) 584-4000
NPI assigned
May 22, 2007
Last updated
Jul 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 50570 CO Primary
Emergency Medicine Physician 207P00000X 2010-00555 NC
Emergency Medicine Physician 207P00000X 5101016931 MI

Addresses

Primary practice location

400 W 16TH St
Pueblo, CO 81003-2745

Mailing address

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4036

Other identifiers 1

IdentifierTypeStateIssuer
02476771MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111216000265 CO Practitioner - Emergency Medicine 4183754104 Reassigns benefits to 2 organizations
I20260409001004 TX Practitioner - Emergency Medicine 4183754104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Chicago College of Medicine and Surgery, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4701 Cox Rd
Suite 400
Glen Allen, VA 23060-6802

501 Corporate Centre Dr
Suite 600
Franklin, TN 37067-2659

9 Executive Campus
Cherry Hill, NJ 08002-4502

909 NE Loop
410 Suite 600
San Antonio, TX 78209-1309

PO Box
Suite 1608
Grand Rapids, MI 49501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
50570COMDEmergency Medicine Physician
5101016931MIMDEmergency Medicine Physician
2010-00555NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews-Vu Medical Group, P.C. CurrentSince Sep 4, 2018 Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Sep 4, 2018 Accepting new patients
Matthews-Vu Medical Group, P.C. Current Accepting new patients
Emergency Medicine Physicians of Craven County, PLLC Emergency Medicine Past Accepting new patients

Locations

104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1811106354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4036",
            "fax_number": "970-490-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032745",
            "telephone_number": "719-584-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKMAN",
        "first_name": "KARI",
        "middle_name": "ANN STENERSON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "50570",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2010-00555",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101016931",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02476771",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.