PUEBLO SPORTS AND FAMILY MEDICINE PLLC (NPI# 1225525132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225525132 |
| Entity Type | Organization |
| Organization Name | PUEBLO SPORTS AND FAMILY MEDICINE PLLC |
| Practice Address |
1315 Fortino Blvd Ste C Pueblo CO 81008-1981 |
| Practice Telephone | 7195442740 |
| Mailing Telephone | 7195442740 |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-22 |
| Authorized Official Name | MR. RAKESH KHOSLA (PRESIDENT) |
| Authorized Official Telephone | 7195442740 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
543004 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 1268788 | 05 | |
| CO | PA NUMBER | 0004910 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Pueblo Sports and Family Medicine PLLC | 1315 Fortino Blvd, Suite C, Pueblo, CO 81008 |
| Street Address |
1315 FORTINO BLVD STE C |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1981 |
| 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 | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205112596 | Catholic Health Initiatives Colorado | Family Medicine | 1315 Fortino Blvd, Pueblo, CO 81008-1981 | 2011-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093338840 | St Mary's Hospital and Medical Center, Inc | Family Medicine | 2698 Patterson Rd Unit 42, Grand Junction, CO 81506-8818 | 2020-05-27 |
| 1356980940 | Catholic Health Initiatives Colorado | Family Medicine | 4925 N Nevada Ave, Colorado Springs, CO 80918-8600 | 2019-12-30 |
| 1013274281 | Sports and Family Medicine of Colorado | Family Medicine | 6390 Gardenia St Unit 140, Arvada, CO 80004-3536 | 2012-04-12 |
| 1407142623 | John D. Breck | Family Medicine | 1900 Wardenburg Way, Boulder, CO 80309 | 2011-06-27 |
| 1316184120 | 10k Sports Medicine, PC | Family Medicine | Unit 101b, 12 Snowmass Rd, Crested Butte, CO 81224-8046 | 2009-01-15 |
| 1497908362 | All Sports Medicine of Boulder | Family Medicine | 3825 Iris Ave, Suite 300, Boulder, CO 80301-2003 | 2008-10-23 |
| 1740467315 | Workpartners | Family Medicine | 1060 Orchard Ave Unit O, Grand Junction, CO 81501-2997 | 2008-01-26 |
| 1578686382 | Lisa Brone | Family Medicine | 149 S Briggs St, Ste 103b, Erie, CO 80516-4064 | 2007-04-08 |
| 1861547572 | Girish Anand Paranjape | Family Medicine | 2240 Buchtel Blvd, 3rd Floor Clinic - Ritchie Center, Denver, CO 80208-0001 | 2007-01-24 |
| 1144305038 | Herbert G Parris | Family Medicine | 2610 E 3rd Ave, Denver, CO 80206-4721 | 2006-10-26 |
| 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.