NPIMap

Organization Active NPI

Colorado Department of Corrections

  • Prison Health Clinic/Center
  • Pueblo, CO
National Provider Identifier
1972493930
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
COLORADO DEPARTMENT OF CORRECTIONS
Practice address
1300 West 13TH St
Yos Medical
Pueblo, CO 81003
Phone
(719) 583-5579
Fax
(719) 583-5585
NPI assigned
Jul 9, 2025
Organization subpart
Yes
Parent organization
STATE OF COLORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Dr. Randolph Maul, MD
Title
Chief Medical Officer
Phone
(719) 306-2821

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary

Addresses

Primary practice location

1300 West 13TH St
Yos Medical
Pueblo, CO 81003

Mailing address

1300 West 13TH St
Yos Medical
Pueblo, CO 81003
Phone (719) 583-5579

Other names 1

  • Youth Offender System Other name

National Provider Directory

National Provider Directory
Tax ID family
Colorado State Veterans Nursing Home102 organizations share this tax ID, including this one
Part of
Colorado State Veterans Nursing Home

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

1300 W 13th St
Pueblo, CO 81003
Phone (719) 583-5560

NPI Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1972493930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 WEST 13TH ST",
            "address_2": "YOS MEDICAL",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81003",
            "telephone_number": "719-583-5579",
            "fax_number": "719-583-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 WEST 13TH ST",
            "address_2": "YOS MEDICAL",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81003",
            "telephone_number": "719-583-5579",
            "fax_number": "719-583-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DEPARTMENT OF CORRECTIONS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF COLORADO",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "MAUL",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "719-306-2821",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youth Offender System",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 14, 2025; 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.