NPIMap

Organization Active NPI

Soaring Eagles Center for Autism

  • Behavior Analyst
  • Pueblo West, CO
National Provider Identifier
1851113732
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
SOARING EAGLES CENTER FOR AUTISM
Practice address
125 W Palmer Lake Dr
Pueblo West, CO 81007-2876
Phone
(719) 547-8803
Fax
(719) 547-8806
NPI assigned
Oct 30, 2024
Last updated
Oct 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Karen W. Colvin-Whitaker, MD
Title
Executive Director
Phone
(719) 547-8803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

125 W Palmer Lake Dr
Pueblo West, CO 81007-2876

Mailing address

PO Box 7878
Pueblo West, CO 81007-0878
Phone (719) 547-8803

Other names 1

  • SOARING EAGLES CENTER FOR AUTISM - BEHAVIORAL CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Soaring Eagles Center for Autism3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

125 W Palmer Lake Dr
Pueblo West, CO 81007
Phone (719) 547-8803

NPI Registry JSON

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1851113732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7878",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810070878",
            "telephone_number": "719-547-8803",
            "fax_number": "719-547-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W PALMER LAKE DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810072876",
            "telephone_number": "719-547-8803",
            "fax_number": "719-547-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOARING EAGLES CENTER FOR AUTISM",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "COLVIN-WHITAKER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-547-8803",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOARING EAGLES CENTER FOR AUTISM - BEHAVIORAL CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 30, 2024; 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.