Individual provider Active NPI

Quazi Parvin, M.D.

  • Pediatrics Physician
  • Pueblo, CO
National Provider Identifier
1851378749
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
43488 Issued in CO
Practice address
3676 Parker Blvd
Suite# 260
Pueblo, CO 81008-2212
Phone
(719) 553-2204
Fax
(719) 553-2222
NPI assigned
Dec 30, 2005
Last updated
Apr 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 43488 CO Primary

Addresses

Primary practice location

3676 Parker Blvd
Suite# 260
Pueblo, CO 81008-2212

Mailing address

5402 Peregrine Dr
Pueblo, CO 81005-5538

Other identifiers 1

IdentifierTypeStateIssuer
88981541MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43488COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Clinic PC Past Accepting new patients
Southern Colorado Clinic PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: quazi.parvin.1@21306.direct.athenahealth.com

Organizations & group practices 2

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1851378749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5402 PEREGRINE DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810055538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "address_2": "SUITE# 260",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "719-553-2204",
            "fax_number": "719-553-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARVIN",
        "first_name": "QUAZI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "43488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88981541",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; 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.