Children's Clinic of Pueblo, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

36942 Issued in CO

Legal business name

CHILDREN'S CLINIC OF PUEBLO, PC

Practice address

1600 N Grand Ave
Suite 240
Pueblo, CO 81003-2700

Phone

(719) 295-2305

Fax

(719) 295-2320

NPI assigned

Jan 15, 2007

Last updated

Dec 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Loraine L. Carroll, M.D.NPI 1801828850

Title

Physician

Phone

(719) 295-2305

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Loraine Lynn Carroll, M.D.

  • Pediatrics Physician
  • Pueblo, CO
  • NPI 1801828850
  NPD (past) Authorized official
• Jamie Hug, D.O.

  • Pediatrics Physician
  • Colorado Springs, CO
  • NPI 1245623693
  NPD (past)
• Rachel Lynae Schultz, DO

  • Pediatrics Physician
  • Lexington, KY
  • NPI 1023646551
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1962553172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE 240",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032700",
            "telephone_number": "719-295-2305",
            "fax_number": "719-295-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE 240",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032700",
            "telephone_number": "719-295-2305",
            "fax_number": "719-295-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CLINIC OF PUEBLO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "LORAINE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "719-295-2305",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "36942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Chingan Chen
• Elisabeth Mary Cheney, M.D.
• Jefferey Chheuy, PHARMD
• Trey Enzelow Chick
• Tad D Childers
• Children's Hospital Colorado (Children's Colorado Regional Outreach Clinic - Pueblo - A&AA)
• Children's Hospital Colorado (Children's Colorado Regional Outreach Clinic - Pueblo - CS)
• Children's Hospital Colorado
• Frank Burton Childress, DDS
• Kriss L Childress, RDH

• Pediatrics Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.