SOUTHERN COLORADO HEALTH & REHAB (NPI# 1093322547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093322547 |
| Entity Type | Organization |
| Organization Name | SOUTHERN COLORADO HEALTH & REHAB |
| Practice Address |
1630 Fortino Blvd Pueblo CO 81008-1856 |
| Mailing Address |
Po Box 5718 Kalispell MT 59903-5718 |
| Practice Telephone | 7192813184 |
| Practice Fax Number | 7192994088 |
| Mailing Telephone | 4067560134 |
| Mailing Fax Number | 4063001612 |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2020-09-29 |
| Authorized Official Name | BLAINE STIMAC (MANAGING MEMBER) |
| Authorized Official Telephone | 4067561128 |
| Authorized Official Credential | MSPT |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHERN COLORADO HEALTH & REHAB LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Momentum Physical Therapy of Pueblo | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548877095 | Southern Colorado Health & Rehab | Clinic/Center | 387 E Enterprise Dr Ste 160, Pueblo, CO 81007-8403 | 2020-09-29 |
| 1295198067 | Southern Colorado Health & Rehab | Physical Therapist | 1275 W Pueblo Blvd, Pueblo, CO 81004 | 2016-03-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Southern Colorado Health & Rehab, LLC | 690 N Meridian Rd., Ste. 201, Kalispell, MT 59901 |
| Street Address |
1630 FORTINO BLVD |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1856 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306822556 | Alan M Takaki | Dentist | 1630 Fortino Blvd, Pueblo, CO 81008-1856 | 2005-12-20 |
| 1649661737 | Debra Giordano | Dental Hygienist | 1630 Fortino Blvd, Pueblo, CO 81008-1856 | 2015-02-10 |
| 1821488982 | Samantha Thompson | Dental Hygienist | 1630 Fortino Blvd, Pueblo, CO 81008-1856 | 2015-01-28 |
| 1841561024 | Alan M Takaki Takaki Dental Care Center | Dentist | 1630 Fortino Blvd, Pueblo, CO 81008-1856 | 2012-01-20 |
| 1497042493 | Jeremy V Thomas | Dentist | 1630 Fortino Blvd, Pueblo, CO 81008-1856 | 2011-06-29 |
| 1851623912 | Lorraine Kay Jubic | Dental Hygienist | 1630 Fortino Blvd, Pueblo, CO 81008-1856 | 2010-01-31 |
| 1306970017 | Med Tel International Corporation | Clinic/Center | 1630 Fortino Blvd, Pueblo, CO 81008-1856 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588203632 | Parkview Medical Center, Inc | Clinic/Center | 3676 Parker Blvd Ste 330, Pueblo, CO 81008-2213 | 2020-01-06 |
| 1437572583 | Synergy Physical Therapy and Wellness | Clinic/Center | 1080 Eagleridge Blvd, Pueblo, CO 81008-2130 | 2014-01-26 |
| 1104116003 | Becky Joann Martin | Clinic/Center | 100 San Carlos Rd Apt 310, Pueblo, CO 81005-2665 | 2011-04-12 |
| 1073784500 | Kathe Davis, Pt, Pllc | Clinic/Center | 511 West 29th St, Suite B, Pueblo, CO 81008 | 2008-03-12 |
| 1174642045 | Physical Therapy Connections, PC | Clinic/Center | 58 Glen Royal Dr, Pueblo, CO 81005-2174 | 2007-03-29 |
| 1548877095 | Southern Colorado Health & Rehab | Clinic/Center | 387 E Enterprise Dr Ste 160, Pueblo, CO 81007-8403 | 2020-09-29 |
| 1730711862 | Centura Ventures, LLC | Clinic/Center | 4112 Outlook Blvd Ste 96, Pueblo, CO 81008-1667 | 2020-02-06 |
| 1417596834 | Parkview Medical Center, Inc | Clinic/Center | 3204 E Spaulding Ave, Pueblo, CO 81008-2279 | 2020-01-02 |
| 1841627858 | Back In Action, LLC | Clinic/Center | 3673 Parker Blvd, Suite 160, Pueblo, CO 81008-2210 | 2013-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629811 | Alpenstrong Physical Therapy LLC | Clinic/Center | 166 S Saint Vrain Ave, Estes Park, CO 80517-6355 | 2020-11-08 |
| 1467052258 | Panorama Orthopedics and Spine Center PC | Clinic/Center | 1402 S Parker Rd Ste A116, Denver, CO 80231-2758 | 2020-10-29 |
| 1942808548 | Panorama Orthopedics and Spine Center PC | Clinic/Center | 2706 28th St, Boulder, CO 80301-1222 | 2020-10-15 |
| 1477150597 | Anchor Physical Therapy & Wellness, Pllc | Clinic/Center | 1020 Nancy St, Fort Morgan, CO 80701-3726 | 2020-10-01 |
| 1952917056 | Uch-mhs | Clinic/Center | 5818 North Nevada, Suite 200, Colorado Springs, CO 80918 | 2020-09-23 |
| 1356957757 | Monument Physical Therapy LLC | Clinic/Center | 406 Chipeta Ave, Grand Junction, CO 81501-2532 | 2020-09-21 |
| 1699389288 | New Morning Physical Therapy, LLC | Clinic/Center | 6440 Tacoma Ct, Colorado Springs, CO 80915-4318 | 2020-09-01 |
| 1306455845 | Ascension Physical Therapy, Fitness and Wellness LLC | Clinic/Center | 600 S Cherry St Ste 230, Denver, CO 80246-1714 | 2020-07-30 |
| 1154930345 | Unbound Physical Therapy LLC | Clinic/Center | 3621 S Kalispell St, Aurora, CO 80013-2435 | 2020-07-23 |
| 1629686894 | Panorama Orthopedics & Spine Center, PC | Clinic/Center | 5540 Main Street, Suite #200, Westminster, CO 80031 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.