SSC PUEBLO OPERATING COMPANY LLC (NPI# 1881715910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881715910 |
| Entity Type | Organization |
| Organization Name | SSC PUEBLO OPERATING COMPANY LLC |
| Other Organization Name | MINNEQUA MEDICENTER |
| Practice Address |
2701 California St Pueblo CO 81004-3869 |
| Mailing Address |
5300 W Sam Houston Pkwy N Suite 100 Houston TX 77041-5161 |
| Practice Telephone | 7195611300 |
| Mailing Telephone | 8324676000 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2015-04-09 |
| Authorized Official Name | KELLE C SANTORO (SR DIRECTOR AR) |
| Authorized Official Telephone | 8324675728 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 385H00000X | Respite Care | 0004 | CO | Respite Care Facility |
| Y | 314000000X | Skilled Nursing Facility | 0004 | CO | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 53273761 | 05 | |
| CO | 01627015 | 05 |
| Other Name | Type Code |
|---|---|
| Minnequa Medicenter | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235620840 | Ssc Pueblo Operating Company LLC | Respite Care | 2701 California St, Pueblo, CO 81004-3869 | 2018-05-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | SSC Pueblo Operating Company LLC | 8601 Dunwoody Place, Suite 775, Sandy Springs, GA 30350 |
| Street Address |
2701 CALIFORNIA ST |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004-3869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487203501 | Jeannie Ballejos | Physical Therapy Assistant | 2701 California St, Pueblo, CO 81004-3869 | 2019-09-11 |
| 1558910646 | Frances Espiritu | Physical Therapist | 2701 California St, Pueblo, CO 81004-3869 | 2019-09-10 |
| 1104475623 | Thomas Matt Martinez | Physical Therapy Assistant | 2701 California St, Pueblo, CO 81004-3869 | 2019-09-06 |
| 1265081996 | Aaron Burl Sheets | Occupational Therapist | 2701 California St, Pueblo, CO 81004-3869 | 2019-09-05 |
| 1235620840 | Ssc Pueblo Operating Company LLC | Respite Care | 2701 California St, Pueblo, CO 81004-3869 | 2018-05-21 |
| 1356508725 | Helen M. Gonzales | Social Worker | 2701 California St, Pueblo, CO 81004-3869 | 2008-05-21 |
| 1255516779 | Robert Neil Saltzman | Speech-Language Pathologist | 2701 California St, Pueblo, CO 81004-3869 | 2008-01-03 |
| 1811197056 | Laurence Lopez | Family Medicine | 2701 California St, Pueblo, CO 81004-3869 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1194148940 | Rose Marie Javornik | Skilled Nursing Facility | 5601 Verde Rd, Pueblo, CO 81004-9735 | 2014-01-30 |
| 1366881237 | Wsi Personel | Skilled Nursing Facility | 2610 Hollywood Dr, Pueblo, CO 81005-3313 | 2013-06-24 |
| 1588954598 | Mariah Lynn Mikulas | Skilled Nursing Facility | 2724 Franklin Ave, Pueblo, CO 81003-1330 | 2011-04-11 |
| 1891882957 | South Pueblo Medical Investors, LLC | Skilled Nursing Facility | 2118 Chatalet Ln, Pueblo, CO 81005-4625 | 2006-10-09 |
| 1265537591 | Continuum At Sharmar, Inc. | Skilled Nursing Facility | 1201 W Abriendo Ave, Pueblo, CO 81004-1003 | 2006-09-13 |
| 1861508822 | Catholic Health Initiatives Colorado | Skilled Nursing Facility | 1111 Bonforte Blvd, Pueblo, CO 81001-1801 | 2006-08-22 |
| 1922000371 | Pitman Place, LLC | Skilled Nursing Facility | 1610 Scranton Ave, Pueblo, CO 81004-2676 | 2005-08-15 |
| 1619978426 | Pitman Place, LLC | Skilled Nursing Facility | 2515 Pitman Pl, Pueblo, CO 81004-2633 | 2005-08-02 |
| 1801418256 | Center At Park West, LLC | Skilled Nursing Facility | St. Mary Corwin Medical Center, 1008 Minnequa Avenue, Pueblo, CO 81004 | 2020-05-08 |
| 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.