NPIMap

Organization Active NPI

Southern Colorado Psychiatric P.C.

  • Psychiatry Physician
  • Pueblo, CO
National Provider Identifier
1912028564
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SOUTHERN COLORADO PSYCHIATRIC P.C.
Practice address
1925 E Orman Ave Ste G12
Pueblo, CO 81004-3563
Phone
(719) 564-1800
Fax
(719) 564-1865
NPI assigned
Apr 2, 2007
Last updated
Jul 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Authorized official

Name
Ms. Mary Wright
Title
Authorized Agent
Phone
(719) 564-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1925 E Orman Ave Ste G12
Pueblo, CO 81004-3563

Mailing address

1925 E Orman Ave Ste G12
Pueblo, CO 81004-3563
Phone (719) 564-1800

National Provider Directory

National Provider Directory

Locations

1925 E Orman Ave
Ste G12
Pueblo, CO 81004
Phone (719) 564-1800

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1912028564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 E ORMAN AVE STE G12",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043563",
            "telephone_number": "719-564-1800",
            "fax_number": "719-564-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 E ORMAN AVE STE G12",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043563",
            "telephone_number": "719-564-1800",
            "fax_number": "719-564-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COLORADO PSYCHIATRIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "719-564-1800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 13, 2009; 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.