NPIMap

Organization Active NPI

Interim Healthcare of Southeastern Colorado, Inc.

Doing business as Interim Healthcare

  • Home Health Agency
  • Pueblo, CO
National Provider Identifier
1891762316
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
INTERIM HEALTHCARE OF SOUTHEASTERN COLORADO, INC.
Doing business as
Interim Healthcare
Practice address
720 N Main St
Suite 400
Pueblo, CO 81003-3020
Phone
(719) 545-1184
Fax
(719) 545-1746
NPI assigned
Mar 2, 2006
Last updated
Apr 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Authorized official

Name
Mrs. Cynthia Ringling, RN
Title
Cco
Phone
(719) 632-9900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
In Home Supportive Care Agency 253Z00000X 040680 CO
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

720 N Main St
Suite 400
Pueblo, CO 81003-3020

Mailing address

720 N Main St
Suite 400
Pueblo, CO 81003-3020
Phone (719) 545-1184

Other identifiers 2

IdentifierTypeStateIssuer
040680OtherCOCOLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
42137063MedicaidCO

Other names 1

  • Interim Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160527001451 CO Part A Provider - Home Health Agency 0648455683 Practice locations: Pueblo, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891762316. Details of each certification follow.

Home health agency certification: CCN 067337

Legal name
INTERIM HEALTHCARE OF SOUTHEASTERN COLORADO, INC
Doing business as
INTERIM HEALTHCARE OF PUEBLO
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 29, 2000
Last certification
Dec 5, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 6, 1976 in CO
Enrollment address
720 N Main St
Ste 400
Pueblo, CO 81003-3048

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Interim Healthcare of PuebloCCN 067337 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Feb 29, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0703029Interim Healthcare of Pueblo720 N Main St, Suite 400, Pueblo, CO 81003Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Interim Healthcare of SE Co7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Devin Jay Ringling Individual 5% Or Greater Direct Ownership InterestCeo Jul 1, 1999 50%
Corporate OfficerCeo Jul 1, 1999
Corporate DirectorCeo Jul 1, 1999
Cynthia Jane Ringling Individual 5% Or Greater Direct Ownership InterestChiief Clinical Officer Jul 1, 1999 50%
Corporate OfficerChief Clinical Officer Feb 29, 2000
Corporate DirectorChief Clinical Officer Feb 29, 2000
Claudyne Blackwood Individual W-2 Managing EmployeeDirector of Healthcare Services Feb 6, 2023 50%
Operational/Managerial ControlDirector of Healthcare Services Feb 6, 2023 50%
Catherine Konaszewski Individual W-2 Managing EmployeeAdministrator Feb 8, 2021 60%
Operational/Managerial ControlAdministrator Feb 8, 2021 60%

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Interim HealthcareFort Collins, CO, CCN 067253 Home health agency Operational/Managerial Control (25%) Jan 1, 1995
Interim HealthcareTucson, AZ, CCN 037016 Home health agency Operational/Managerial Control (50%) Sep 1, 2012

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555545600000",
    "number": "1891762316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N MAIN ST",
            "address_2": "SUITE 400",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033020",
            "telephone_number": "719-545-1184",
            "fax_number": "719-545-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N MAIN ST",
            "address_2": "SUITE 400",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033020",
            "telephone_number": "719-545-1184",
            "fax_number": "719-545-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE OF SOUTHEASTERN COLORADO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2019-04-18",
        "status": "A",
        "authorized_official_last_name": "RINGLING",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "719-632-9900",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CO",
            "license": "040680",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT",
            "identifier": "040680",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42137063",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interim Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Interim Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.