Avila Integrative Medicine, Inc.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

31499 Issued in CO

Legal business name

AVILA INTEGRATIVE MEDICINE, INC.

Practice address

3960 Ivywood LN
Pueblo, CO 81005-2567

Phone

(719) 565-1276

Fax

(719) 565-2313

NPI assigned

Mar 13, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Robert J Avila, D.C., CCST, CCCNNPI 1245248400

Title

President

Phone

(719) 565-1276

Specialties & licenses 3

Addresses

Other names 1

• Avila Integrative Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 2

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

• Robert Joseph Avila, D.C., CCST, CCCN

  • Chiropractor
  • Pueblo, CO
  • NPI 1245248400
  Medicare reassignment NPD Authorized official
• Juan Ruben Lopez Jr., OTR

  • Occupational Therapist
  • Colorado Springs, CO
  • NPI 1205151339
  Medicare reassignment NPD

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1821363557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 IVYWOOD LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052567",
            "telephone_number": "719-565-1276",
            "fax_number": "719-565-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 IVYWOOD LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052567",
            "telephone_number": "719-565-1276",
            "fax_number": "719-565-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVILA INTEGRATIVE MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-565-1276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., CCST, CCCN"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "4867",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CO",
            "license": "31499",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7987",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avila Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Desiree Autobee
• Nancy Autobee
• Thomas V Autobee, DDS PC
• Armine Avanesyan, M.D.
• Sean D Averill, PHARM. D.
• Robert Joseph Avila, D.C., CCST, CCCN
• Sophia Madalena Avila
• Karen Ayala, RDH
• Melissa Ayala
• Samantha M Ayala

• Pain Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Pain Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.