NPIMap

Organization Active NPI

South Pueblo Medical Investors, LLC

Doing business as Life Care Center of Pueblo

  • Skilled Nursing Facility
  • Pueblo, CO
National Provider Identifier
1891882957
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0600 Issued in CO
Legal business name
SOUTH PUEBLO MEDICAL INVESTORS, LLC
Doing business as
Life Care Center of Pueblo
Practice address
2118 Chatalet LN
Pueblo, CO 81005-4625
Phone
(719) 564-2000
Fax
(719) 564-7741
NPI assigned
Oct 9, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Cindy S Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0600 CO Primary

Addresses

Primary practice location

2118 Chatalet LN
Pueblo, CO 81005-4625

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other identifiers 1

IdentifierTypeStateIssuer
05650742MedicaidCO

Other names 1

  • Life Care Center of Pueblo Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040802001099 CO Part A Provider - Skilled Nursing Facility 6305817644 Practice locations: Pueblo, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891882957. Details of each certification follow.

Skilled nursing facility certification: CCN 065269

Legal name
SOUTH PUEBLO MEDICAL INVESTORS, LLC
Doing business as
LIFE CARE CENTER OF PUEBLO
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 21, 1989
Last certification
May 9, 2024
Beds
187
Ownership / control type
Corporation
Multi-facility organization
Life Care Centers of America Inc
Organization structure
LLCProprietary
Enrollment address
2118 Chatalet LN
Pueblo, CO 81005-4625
Nursing home name
LIFE CARE CENTER OF PUEBLO
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of PuebloCCN 065269 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 21, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
187106.3 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain
Penalties (3 years)
2Fines totaling $18,685

Processed by Care Compare on Aug 1, 2026.

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
06D0688746Life Care Center of Pueblo2118 Chatalet Lane, Pueblo, CO 81005Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Forrest L Preston Individual 5% Or Greater Direct Ownership InterestMember Feb 1, 1988 99%
Joan E Thurmond Individual Corporate OfficerAssist. Secretary of Corp. MGR. Sep 21, 2000
Cindy S Cross Individual Corporate OfficerVP of Corporate Manager Feb 3, 1994
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, Management services company, For-profit Operational/Managerial Control Sep 20, 1989 100%
Roberto Newman Individual W-2 Managing EmployeeAdministrator Jul 18, 2016

Owners & managing parties with NPI records 25

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 25

Facilities with the same owner 193

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 193

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1891882957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 CHATALET LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810054625",
            "telephone_number": "719-564-2000",
            "fax_number": "719-564-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PUEBLO MEDICAL INVESTORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "0600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05650742",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Pueblo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.