NPIMap

Organization Active NPI

Southern Colorado Clinic PC

  • Clinic/Center
  • Pueblo West, CO
National Provider Identifier
1831705300
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SOUTHERN COLORADO CLINIC PC
Practice address
109 S Burlington Dr
Pueblo West, CO 81007-5560
Phone
(719) 553-2205
NPI assigned
Sep 21, 2020
Last updated
Dec 5, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN COLORADO CLINIC PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Authorized official

Name
Jennifer Arellano
Title
Coo
Phone
(719) 553-1801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

109 S Burlington Dr
Pueblo West, CO 81007-5560

Mailing address

PO Box 9000
Pueblo, CO 81008-9000
Phone (719) 553-2200

National Provider Directory

National Provider Directory
Tax ID family
Southern Colorado Clinic PC6 organizations share this tax ID, including this one
Part of
Southern Colorado Clinic PC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1831705300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9000",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810089000",
            "telephone_number": "719-553-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S BURLINGTON DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810075560",
            "telephone_number": "719-553-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COLORADO CLINIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN COLORADO CLINIC PC",
        "enumeration_date": "2020-09-21",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "ARELLANO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "719-553-1801"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo West, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.