COLORADO DEPARTMENT OF CORRECTIONS (NPI# 1669530192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669530192 |
| Entity Type | Organization |
| Organization Name | COLORADO DEPARTMENT OF CORRECTIONS |
| Other Organization Name | SAN CARLOS CORRECTIONAL FACILITY |
| Practice Address |
1410 W 13th St Pueblo CO 81003-1961 |
| Practice Telephone | 7195835559 |
| Practice Fax Number | 7195835525 |
| Mailing Telephone | 7195835559 |
| Mailing Fax Number | 7195835525 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DONALD R LAWSON (PHYSICIAN'S ASSISTANT) |
| Authorized Official Telephone | 7195835559 |
| Authorized Official Credential | P.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2400X |
Clinic/Center Specialization: Prison Health |
391 | CO | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| San Carlos Correctional Facility | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255831665 | Colorado Department of Corrections | Clinic/Center | 1250 Academy Park Loop, Colorado Springs, CO 80910-3708 | 2018-02-13 |
| 1386196665 | Colorado Department of Corrections | Point of Service | 49030 State Hwy 71, Limon, CO 80826-0001 | 2016-11-02 |
| 1033430442 | Colorado Department of Corrections | Exclusive Provider Organization | 1410 W 13th St, Pueblo, CO 81003-1961 | 2010-06-21 |
| Street Address |
1410 W 13TH ST |
| City | PUEBLO |
| State | CO |
| Zip Code | 81003-1961 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669783296 | Joseph John Wermers | General Practice | 1410 W 13th St, Pueblo, CO 81003-1961 | 2010-06-29 |
| 1033430442 | Colorado Department of Corrections | Exclusive Provider Organization | 1410 W 13th St, Pueblo, CO 81003-1961 | 2010-06-21 |
| 1205004421 | Joan Koprivnikar | Psychiatry & Neurology | 1410 W 13th St, Pueblo, CO 81003-1961 | 2008-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042016 | Sunil Kumar | Student in an Organized Health Care Education/Training Program | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2020-04-21 |
| 1497382303 | Pueblo Family Dentistry Pllc | Dentist | 701 N Grand Avenue, Suite B, Pueblo, CO 81003 | 2020-03-23 |
| 1023654241 | Elmer A. Villalon, Dmd, LLC | Clinic/Center | 1225 North Main Street, #207, Pueblo, CO 81003 | 2019-11-22 |
| 1518434349 | Mariam Rahim | Internal Medicine | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-10-30 |
| 1003308222 | Julia Mcneice | Internal Medicine | Parkview Medial Center, Parkveiw Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-06-04 |
| 1689164857 | Jessica Sels | Internal Medicine | Parkview Medical Center Adult Medicine Clinic, 311 W 14th St, Pueblo, CO 81003 | 2018-05-14 |
| 1700313459 | Allison Vigil | Occupational Therapist | 1600 W. 24th St, Pueblo, CO 81003 | 2017-05-12 |
| 1245682020 | Paul S Bongat | Internal Medicine | 411 W. 14th St., Parkview Adult Medicine Clinic, Pueblo, CO 81003 | 2016-07-06 |
| 1013368596 | Daniel R Long | Internal Medicine | 411 West 14th Street, Pueblo, CO 81003 | 2016-06-27 |
| 1396195665 | Parkview Medical Center | General Acute Care Hospital | 411 W. 14th St, Pueblo, CO 81003 | 2016-06-17 |
| Find all providers in zip 81003 | ||||
| Taxonomy Code | 261QP2400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Prison Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538580774 | Federal Bureau of Prisons | Clinic/Center | 5880 State Highway 67, Florence, CO 81226-9791 | 2013-12-13 |
| 1508487539 | Correctional Health Partners, LLC | Clinic/Center | 1125 17th St Ste 1000, Denver, CO 80202-2043 | 2020-04-30 |
| 1407390586 | Department of Justice | Clinic/Center | 9595 W Quincy Ave, Littleton, CO 80123-1159 | 2016-12-08 |
Please comment or provide details below to improve the information on COLORADO DEPARTMENT OF CORRECTIONS.
| 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.