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SOUTHERN COLORADO CLINIC PC NPI 1598371056


NPI Information

NPI: 1598371056
Provider Name: SOUTHERN COLORADO CLINIC PC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 06D1084057

Address:
3937 IVYWOOD LN
PUEBLO, CO
ZIP 81005
Phone: (719) 553-0111
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SOUTHERN COLORADO CLINIC PC is a clinic center in Pueblo, CO. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SOUTHERN COLORADO CLINIC PC NPI is 1598371056. The provider is registered as an organization entity type.

The provider's business location address is:

3937 IVYWOOD LN
PUEBLO, CO
ZIP 81005-551
Phone: (719) 553-0111

The provider's authorized official is Kathy Lynn Kelley .
The authorized official title is Admin Service Coor. and has the following contact phone number (719) 553-1802.

The CLIA number assigned to this NPI record is 06D1084057 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/21/2020 and was last updated on 9/21/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.