NPIMap

Organization Active NPI

Spanish Peaks New Alternatives, Inc.

Doing business as Perry Hall PC

  • Primary Care Clinic/Center
  • Pueblo, CO
National Provider Identifier
1922848738
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SPANISH PEAKS NEW ALTERNATIVES, INC.
Doing business as
Perry Hall PC
Practice address
1591 Taos Rd
Pueblo, CO 81006-1232
Phone
(719) 545-2746
NPI assigned
May 29, 2024
Last updated
Aug 14, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SPANISH PEAKS NEW ALTERNATIVES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Jennifer Rudnik, MPMNPI 1235001835
Title
Credentialing Manager
Phone
(719) 423-1341

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Primary Care Clinic/Center 261QP2300X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

1591 Taos Rd
Pueblo, CO 81006-1232

Mailing address

41 Montebello Rd Ste 204
Pueblo, CO 81001-1379
Phone (719) 545-2746

Other names 1

  • Perry Hall PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160128000583 CO Part B Supplier - Clinic/Group Practice 4385947134 Receives reassigned benefits from 23 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pueblo, CO; Grand Junction, CO; Canon City, CO

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Health Solutions Family Practice and Walk-in Clinic12 organizations share this tax ID, including this one
Part of
Health Solutions Family Practice and Walk-in Clinic

Other organizations with this tax ID 11

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

Locations

41 Montebello Rd
Ste 116
Pueblo, CO 81001
Phone (719) 423-1500

41 Montebello Rd
Ste 202
Pueblo, CO 81001
Phone (719) 423-1341

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": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1922848738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MONTEBELLO RD STE 204",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011379",
            "telephone_number": "719-545-2746",
            "fax_number": "719-545-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 TAOS RD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810061232",
            "telephone_number": "719-545-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPANISH PEAKS NEW ALTERNATIVES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPANISH PEAKS NEW ALTERNATIVES, INC.",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "RUDNIK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-423-1341",
        "authorized_official_credential": "MPM"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry Hall PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perry Hall PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.