PUEBLO COMMUNITY HEALTH CENTER (NPI# 1013261023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013261023 |
| Entity Type | Organization |
| Organization Name | PUEBLO COMMUNITY HEALTH CENTER |
| Other Organization Name | RISLEY SCHOOL BASED WELLNESS CENTER |
| Practice Address |
625 N Monument Ave Pueblo CO 81001-5706 |
| Mailing Address |
110 E Routt Ave Pueblo CO 81004-2117 |
| Practice Telephone | 7195438711 |
| Practice Fax Number | 7195435340 |
| Mailing Telephone | 7195438711 |
| Mailing Fax Number | 7195435340 |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-11-19 |
| Authorized Official Name | DONALD MOORE (CEO) |
| Authorized Official Telephone | 7195438711 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Risley School Based Wellness Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649524653 | Pueblo Community Health Center | Clinic/Center | 9 Macneil Rd, Pueblo, CO 81001-1931 | 2012-10-30 |
| 1912251927 | Pueblo Community Health Center | Clinic/Center | 715 W 20th St, Pueblo, CO 81003-4052 | 2012-10-30 |
| 1700139813 | Pueblo Community Health Center | Clinic/Center | 206 E Orman, Pueblo, CO 81004 | 2012-10-26 |
| 1396098828 | Pueblo Community Health Center | Clinic/Center | 1050 35th Ln, Pueblo, CO 81006-9426 | 2012-10-22 |
| 1013271329 | Pueblo Community Health Center | Health Maintenance Organization | 300 Colorado Ave, Pueblo, CO 81004-2006 | 2012-07-02 |
| Street Address |
625 N MONUMENT AVE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81001-5706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588222863 | 1111 Bonforte Opco LLC | Respite Care | 855 Hunter Dr., Pueblo, CO 81001 | 2019-06-03 |
| 1992276026 | Andrew Benjamin Basham | Counselor | 1003 Rupple St Pueblo Co 81001, 606, Pueblo, CO 81001 | 2018-12-16 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| 1609146950 | Natasha Liette Mondragon | Registered Nurse | 1302 E. 5th, Pueblo, CO 81001 | 2012-01-04 |
| 1023303575 | Malinda Lee Davis | Registered Nurse | 1302 E 5th, Pueblo, CO 81001 | 2011-06-13 |
| 1679876429 | Michael Edward Leyba | Substance Abuse Rehabilitation Facility | 4 Montebello Rd., Pueblo, CO 81001 | 2010-12-17 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| 1730380882 | Corrine Stella Tafoya | Counselor | 44 Calhoun Rd, Pueblo, CO 81001 | 2007-05-29 |
| 1518171008 | George Henry Beck | Dentist | 1700 N Salem Ave, Suite A, Pueblo, CO 81001 | 2007-05-10 |
| Find all providers in zip 81001 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326607169 | Pueblo Community Health Center, Inc | Clinic/Center | 2500 W 18th St Bldg 11, Pueblo, CO 81003-1152 | 2019-06-06 |
| 1316466816 | Pueblo Community Health Center Inc | Clinic/Center | 900 W Orman Ave Rm Mt118, Pueblo, CO 81004-1430 | 2017-09-15 |
| 1720432610 | Pueblo Community Health Center, Inc | Clinic/Center | 2525 Mountview Dr, Pueblo, CO 81008-1431 | 2016-04-18 |
| 1649524653 | Pueblo Community Health Center | Clinic/Center | 9 Macneil Rd, Pueblo, CO 81001-1931 | 2012-10-30 |
| 1912251927 | Pueblo Community Health Center | Clinic/Center | 715 W 20th St, Pueblo, CO 81003-4052 | 2012-10-30 |
| 1700139813 | Pueblo Community Health Center | Clinic/Center | 206 E Orman, Pueblo, CO 81004 | 2012-10-26 |
| 1396098828 | Pueblo Community Health Center | Clinic/Center | 1050 35th Ln, Pueblo, CO 81006-9426 | 2012-10-22 |
| 1245275932 | Pueblo Community Health Center Inc. | Clinic/Center | 2030 Lake Avenue, Pueblo, CO 81004 | 2006-06-18 |
| 1144589425 | Pueblo Community Health Center, Inc | Clinic/Center | 1008 N Grand Ave, Pueblo, CO 81003-2916 | 2012-05-08 |
| 1245253145 | Pueblo Community Health Center Inc. | Clinic/Center | 110 E Routt Ave, Pueblo, CO 81004-2117 | 2006-07-25 |
| 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.