Carla E Paredes Diaz, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0996203-NP Issued in CO

Practice address

3676 Parker Blvd
Pueblo, CO 81008-2212

Phone

(719) 553-2201

Fax

(833) 916-2047

NPI assigned

Oct 21, 2020

Last updated

May 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Colorado Clinic PCGroup PAC ID 4284524067, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carla.paredes.diaz.1@21306.direct.athenahealth.com

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.

• Southern Colorado Clinic PC

  • Clinic/Center
  • Pueblo, CO
  • NPI 1285613554
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1932708872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 SOUTH DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081755",
            "telephone_number": "719-369-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "719-553-2201",
            "fax_number": "833-916-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAREDES DIAZ",
        "first_name": "CARLA",
        "middle_name": "E",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0996203-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Papsidero, M.D.
• Paradigm Pathways
• Paradigm Recovery LLC
• Paradigm Recovery, LLC
• Paragon Behavioral Health Connections
• Park West Dental PC
• Park West Vision, LLC (Park West Dental & Vision)
• Parker Personal Care Homes
• Andrew Parker, DO
• Hugh Parker, PT

• Family Nurse Practitioner in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.