PUEBLO RADIOLOGICAL GROUP, P.C. (NPI# 1114528908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114528908 |
| Entity Type | Organization |
| Organization Name | PUEBLO RADIOLOGICAL GROUP, P.C. |
| Practice Address |
1020 Lakeview Ave Pueblo CO 81004-3508 |
| Mailing Address |
Po Box 7693 Loveland CO 80537-0693 |
| Practice Telephone | 7195573145 |
| Practice Fax Number | 7195427019 |
| Mailing Telephone | 9706632742 |
| Mailing Fax Number | 9703422093 |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |
| Authorized Official Name | ROBIN L BOYER (AUTH REP/DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 9706632742 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013860 | Pueblo Radiological Group, P.C. | Radiology | 245 Balmoral Way, Colorado Springs, CO 80906-7907 | 2020-11-06 |
| 1154922938 | Pueblo Radiological Group, P.C. | Radiology | 3245 E Hwy 50 Unit E, Canon City, CO 81212-9343 | 2020-11-06 |
| 1548861529 | Pueblo Radiological Group, P.C. | Radiology | 1804 Oakmoor Hts, Colorado Springs, CO 80906-1171 | 2020-11-05 |
| 1063013852 | Pueblo Radiological Group, P.C. | Radiology | 933 Sell Ave, Canon City, CO 81212-4929 | 2020-11-06 |
| 1396346185 | Pueblo Radiological Group, P.C. | Radiology | 4112 Outlook Blvd Ste 255, Pueblo, CO 81008-1667 | 2020-11-06 |
| 1346841129 | Pueblo Radiological Group, P.C. | Radiology | 4112 Outlook Blvd Ste 96, Pueblo, CO 81008-1667 | 2020-11-06 |
| 1699376764 | Pueblo Radiological Group, P.C. | Radiology | 1338 Phay Ave, Canon City, CO 81212-2311 | 2020-11-05 |
| 1962003947 | Pueblo Radiological Group, P.C. | Radiology | 4194 Royal Pine Dr, Colorado Springs, CO 80920-1507 | 2020-11-05 |
| 1013518000 | Pueblo Radiological Group, P.C. | Radiology | 2035 S Pueblo Blvd, Pueblo, CO 81005-2577 | 2020-11-05 |
| 1164023131 | Pueblo Radiological Group, P.C. | Radiology | 4112 Outlook Blvd Ste 37, Pueblo, CO 81008-1667 | 2020-11-05 |
| Street Address |
1020 LAKEVIEW AVE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004-3508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265477046 | Camille George Azar | Specialist | 1020 Lakeview Ave, Pueblo, CO 81004-3508 | 2006-06-17 |
| 1346261161 | Catholic Health Initiatives Colorado | Internal Medicine | 1020 Lakeview Ave, Pueblo, CO 81004-3508 | 2006-07-21 |
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790730810 | Parkwest Imaging, L.l.c | Radiology | 3676 Parker Blvd Suite 165, Pueblo, CO 81008-2212 | 2006-05-24 |
| 1417929373 | Gordon F Gibbs | Radiology | 115 E Riverwalk, Unit 200, Pueblo, CO 81003-3308 | 2006-02-06 |
| 1790767549 | Michael E. Ball | Radiology | 124 W Pitkin Ave, Pueblo, CO 81004-2021 | 2005-11-17 |
| 1396346185 | Pueblo Radiological Group, P.C. | Radiology | 4112 Outlook Blvd Ste 255, Pueblo, CO 81008-1667 | 2020-11-06 |
| 1346841129 | Pueblo Radiological Group, P.C. | Radiology | 4112 Outlook Blvd Ste 96, Pueblo, CO 81008-1667 | 2020-11-06 |
| 1013518000 | Pueblo Radiological Group, P.C. | Radiology | 2035 S Pueblo Blvd, Pueblo, CO 81005-2577 | 2020-11-05 |
| 1164023131 | Pueblo Radiological Group, P.C. | Radiology | 4112 Outlook Blvd Ste 37, Pueblo, CO 81008-1667 | 2020-11-05 |
| 1043811011 | Pueblo Radiological Group, P.C. | Radiology | 729 E Spaulding Ave, Pueblo, CO 81007-3512 | 2020-11-05 |
| 1841421344 | David Abbott | Radiology | 1619 N Greenwood St, Suite 103, Pueblo, CO 81003-2644 | 2009-07-31 |
| 1558523878 | Gabriel Hayden Johnson | Radiology | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2008-06-27 |
| 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.