SOUTHERN COLORADO CLINIC PC (NPI# 1285613554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285613554 |
Entity Type | Organization |
Organization Name | SOUTHERN COLORADO CLINIC PC |
Practice Address |
3676 Parker Blvd Pueblo CO 81008-2212 |
Mailing Address |
Po Box 9000 Pueblo CO 81008-9000 |
Practice Telephone | 7195532200 |
Practice Fax Number | 7195532213 |
Mailing Telephone | 7195532200 |
Mailing Fax Number | 7195532216 |
Enumeration Date | 2006-01-13 |
Last Update Date | 2007-07-18 |
Authorized Official Name | DR. MARK STEWART POTZLER (PRESIDENT) |
Authorized Official Telephone | 7195532200 |
Authorized Official Credential | MEDICAL DOCTOR |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831705300 | Southern Colorado Clinic PC | Clinic/Center | 109 S Burlington Dr, Pueblo West, CO 81007-5560 | 2020-09-21 |
1598371056 | Southern Colorado Clinic PC | Clinic/Center | 3937 Ivywood Ln, Pueblo, CO 81005-2551 | 2020-09-21 |
Street Address |
3676 PARKER BLVD |
City | PUEBLO |
State | CO |
Zip Code | 81008-2212 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922001700 | Stephen D Bast | Physician Assistant | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2005-05-24 |
1255945960 | Jessica Marie Anaya | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2020-09-01 |
1023658713 | Havilah R. Spurlock | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2020-01-09 |
1033625314 | Jennifer Livingston | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2017-12-21 |
1588176341 | Kenneth Morris | Physical Medicine & Rehabilitation | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2017-11-01 |
1053770370 | Parkview Medical Center, Inc | Clinic/Center | 3676 Parker Blvd, Suite 140, Pueblo, CO 81008-2212 | 2016-02-15 |
1124495163 | Kyle Sanders | Physical Therapist | 3676 Parker Blvd, Suite 370, Pueblo, CO 81008-2212 | 2015-08-25 |
1588057319 | James Richard Anderson | Physician Assistant | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2015-03-18 |
1942600150 | Adam Jennings | Physical Therapist | 3676 Parker Blvd, Suite 370, Pueblo, CO 81008-2212 | 2014-08-26 |
1023425386 | Amanda C Fadenrecht | Nurse Practitioner | 3676 Parker Blvd, Suite 260, Pueblo, CO 81008-2212 | 2014-07-18 |
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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 | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427689652 | Parkview Medical Center, Inc | Clinic/Center | 54 Club Manor Dr Ste 101, Pueblo, CO 81008-2605 | 2020-01-27 |
1528608304 | Parkview Medical Center, Inc. | Clinic/Center | 405 W 15th St Ste 210, Pueblo, CO 81003-2743 | 2020-01-09 |
1437647864 | White Crane Acupuncture | Clinic/Center | 2701 N Elizabeth St, Pueblo, CO 81003-3643 | 2018-05-01 |
1265853311 | Vicky J. Lowrance, D.c. | Clinic/Center | 2025 N Norwood Ave, Pueblo, CO 81001-5667 | 2013-12-16 |
1306184056 | Affordable Health Clinic, LLC | Clinic/Center | 900 Indiana Ave St D, Pueblo, CO 81004-8100 | 2013-01-30 |
1598371056 | Southern Colorado Clinic PC | Clinic/Center | 3937 Ivywood Ln, Pueblo, CO 81005-2551 | 2020-09-21 |
1134751712 | Parkview Medical Center, Inc. | Clinic/Center | 3670 Parker Blvd, Pueblo, CO 81008-2285 | 2020-02-11 |
1053954867 | American Currenct Care P.a. | Clinic/Center | 4117 N Elizabeth St, Pueblo, CO 81008-2009 | 2019-10-24 |
1639641152 | Colorado Permanente Medical Group, P.C. | Clinic/Center | 2625 W Pueblo Blvd, Pueblo, CO 80014-5833 | 2018-12-21 |
1912487810 | Kaiser Foundation Health Plan of Colorado | Clinic/Center | 2625 W Pueblo Blvd, Pueblo, CO 81004 | 2018-08-20 |
Find all providers in PUEBLO |
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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.