Family Medical Center LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21599 Issued in CO

Legal business name

FAMILY MEDICAL CENTER LLC

Practice address

517 Colorado Ave
Pueblo, CO 81004-2075

Phone

(719) 543-4016

Fax

(719) 542-6884

NPI assigned

Oct 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Christopher John Smith, M.D.

Title

Owner

Phone

(719) 543-4016

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1982893640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042075",
            "telephone_number": "719-543-4016",
            "fax_number": "719-542-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042075",
            "telephone_number": "719-543-4016",
            "fax_number": "719-542-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-543-4016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "21599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01215995",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "361918",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.