Magnolia Medical Aesthetics, PLLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

MAGNOLIA MEDICAL AESTHETICS, PLLC

Doing business as

Pueblo Primary Care Clinic

Practice address

415 N Grand Ave
Pueblo, CO 81003-3111

Phone

(719) 250-9412

NPI assigned

Feb 28, 2025

Organization subpart

No

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

Authorized official

Name

Ronda Orndoff, DNPNPI 1033515895

Title

Owner/Provider

Phone

(719) 250-9412

Specialties & licenses 2

Addresses

Other names 1

• Pueblo Primary Care Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Ronda Orndoff, NP

  • Acute Care Nurse Practitioner
  • Pueblo, CO
  • NPI 1033515895
  Medicare reassignment NPD Authorized official
• Wendy Rene Archuleta, FNP, AGACNP

  • Family Nurse Practitioner
  • Parker, CO
  • NPI 1538564810
  NPD (past)

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1851198444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1478 43RD LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810069307",
            "telephone_number": "719-250-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033111",
            "telephone_number": "719-250-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL AESTHETICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "ORNDOFF",
        "authorized_official_first_name": "RONDA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "719-250-9412",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pueblo Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Desiree S Maes, CAS
• Kimberly J Maes, P.T., CPED
• Sonya Maes
• Kelsey Carol Maestas, LPCC
• Ruby Joy Maez, R.N.
• Krishna Chandra Mahat, M.D.
• Faisal Mahfooz, MD
• Fernando Ariel Mahmoud, M.D.
• Vincent Ahmed Mahmoud, MS, BCBA, IBA
• Kimberly A Mahoney

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.