| Southern Colorado Clinic Pc | |
|
3676 Parker Blvd Pueblo CO 81008-2212 | |
| (719) 553-2200 | |
| (719) 553-2213 |
| Full Name | Southern Colorado Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3676 Parker Blvd, Pueblo, Colorado |
| Authorized Official Name and Position | Jennifer Arellano (COO) |
| Authorized Official Contact | 7195531801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Colorado Clinic Pc Po Box 9000 Pueblo CO 81008-9000 Ph: (719) 553-2200 | Southern Colorado Clinic Pc 3676 Parker Blvd Pueblo CO 81008-2212 Ph: (719) 553-2200 |
| NPI Number | 1285613554 |
|---|---|
| Provider Enumeration Date | 01/13/2006 |
| Last Update Date | 12/05/2022 |
| Medicare PECOS PAC ID | 4284524067 |
|---|---|
| Medicare Enrollment ID | O20040316001277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285613554 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Dwight K Caughfield |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1235102096 PECOS PAC ID: 3779477294 Enrollment ID: I20040213000275 |
| Provider Name | Rochelle Y. Elijah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376504654 PECOS PAC ID: 1355254541 Enrollment ID: I20040622000169 |
| Provider Name | Cheryl A Cavalli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306841325 PECOS PAC ID: 0446212856 Enrollment ID: I20041028000554 |
| Provider Name | Scott A De Ruiter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093777658 PECOS PAC ID: 9739137266 Enrollment ID: I20050111000642 |
| Provider Name | Stephen G Vialpando |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396772778 PECOS PAC ID: 2567495237 Enrollment ID: I20050913001251 |
| Provider Name | Shannon L Snow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508818428 PECOS PAC ID: 3072529163 Enrollment ID: I20060227000617 |
| Provider Name | Merilee C Briggs Mead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710936968 PECOS PAC ID: 3072525070 Enrollment ID: I20060609000237 |
| Provider Name | Steven J Simerville |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497712921 PECOS PAC ID: 7012955354 Enrollment ID: I20060613000326 |
| Provider Name | Ralph L Bidwell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306966221 PECOS PAC ID: 6406940642 Enrollment ID: I20070919000692 |
| Provider Name | John G Beauman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497722441 PECOS PAC ID: 4587752753 Enrollment ID: I20080604000471 |
| Provider Name | Lisa A Clough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841459690 PECOS PAC ID: 8224104799 Enrollment ID: I20080906000187 |
| Provider Name | Sergio Alberto Murillo Herrera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598923757 PECOS PAC ID: 3870653348 Enrollment ID: I20081114000371 |
| Provider Name | Patrick K Timms |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1861455099 PECOS PAC ID: 7315837119 Enrollment ID: I20091030000138 |
| Provider Name | Jaymie R Ownbey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962735985 PECOS PAC ID: 8820285943 Enrollment ID: I20101214001334 |
| Provider Name | Karen Springfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760766430 PECOS PAC ID: 4789628074 Enrollment ID: I20120127000653 |
| Provider Name | James S Archuleta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316220742 PECOS PAC ID: 0244498160 Enrollment ID: I20120223000661 |
| Provider Name | Mallikarjuna Nallegowda |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1770733743 PECOS PAC ID: 9436391539 Enrollment ID: I20130819000660 |
| Provider Name | Aaron M Fields |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922061522 PECOS PAC ID: 9436162005 Enrollment ID: I20131017001195 |
| Provider Name | Wendy Rene Archuleta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538564810 PECOS PAC ID: 6406171545 Enrollment ID: I20150211001618 |
| Provider Name | Jodi R Trujillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972050615 PECOS PAC ID: 7113208844 Enrollment ID: I20170111001851 |
| Provider Name | Harry J Aragon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366959363 PECOS PAC ID: 8426317710 Enrollment ID: I20180112000058 |
| Provider Name | Jodi Killilea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235647066 PECOS PAC ID: 3072874486 Enrollment ID: I20180228000386 |
| Provider Name | Tarah K Sellner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659865533 PECOS PAC ID: 8527316660 Enrollment ID: I20180806001029 |
| Provider Name | Nicholas Franklin Brookins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215283098 PECOS PAC ID: 2769715598 Enrollment ID: I20190611002128 |
| Provider Name | Julie Esther Ayaad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710524137 PECOS PAC ID: 4981031614 Enrollment ID: I20200219000705 |
| Provider Name | Laura L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598304438 PECOS PAC ID: 2567899917 Enrollment ID: I20200224002150 |
| Provider Name | Brandi L Trujillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902435506 PECOS PAC ID: 1951732569 Enrollment ID: I20200515000421 |
| Provider Name | Jessica M Anaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255945960 PECOS PAC ID: 7113345356 Enrollment ID: I20200921000460 |
| Provider Name | Lindsay M Sweetman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932708013 PECOS PAC ID: 6608287578 Enrollment ID: I20201125000223 |
| Provider Name | Carla E Paredes Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932708872 PECOS PAC ID: 4385056977 Enrollment ID: I20201228000427 |
| Provider Name | Thomas J Centi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588993828 PECOS PAC ID: 0042613275 Enrollment ID: I20210727000213 |
| Provider Name | Rosalyn M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366112880 PECOS PAC ID: 2264830215 Enrollment ID: I20211006001571 |
| Provider Name | Angela Marie Perides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972024453 PECOS PAC ID: 0547532756 Enrollment ID: I20220121002322 |
| Provider Name | Monica Lyn Valdez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225423981 PECOS PAC ID: 9436541232 Enrollment ID: I20220127001078 |
| Provider Name | Christina Proulx |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649901000 PECOS PAC ID: 9032594361 Enrollment ID: I20220922000652 |
| Provider Name | Paul Oldfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396479010 PECOS PAC ID: 1759767940 Enrollment ID: I20220926000517 |
| Provider Name | Hannah Marie Schmitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497462048 PECOS PAC ID: 4284005224 Enrollment ID: I20230130001329 |
| Provider Name | Bethany Lynne Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336853266 PECOS PAC ID: 8325410806 Enrollment ID: I20230209001247 |
| Provider Name | Rachel Elizabeth Whitten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104424795 PECOS PAC ID: 4587078878 Enrollment ID: I20230718004332 |
| Provider Name | Danielle Marie Kizzie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780460592 PECOS PAC ID: 3476909839 Enrollment ID: I20231023000415 |
| Provider Name | Queenter M Kisang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033773627 PECOS PAC ID: 9335473578 Enrollment ID: I20231218002419 |
| Provider Name | Amy Beth Foraker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700665510 PECOS PAC ID: 3971954595 Enrollment ID: I20240109000560 |
| Provider Name | Olufunmilola Ogunmodede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568521573 PECOS PAC ID: 7719135755 Enrollment ID: I20240117003374 |
| Provider Name | Aries Torralba Giabia-mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083473060 PECOS PAC ID: 6901244342 Enrollment ID: I20240404002873 |
| Provider Name | Julia Grace Moore |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417712423 PECOS PAC ID: 8224477179 Enrollment ID: I20240411004047 |
| Provider Name | Kellie Ann Jakubowicz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225884976 PECOS PAC ID: 6901247253 Enrollment ID: I20240516004181 |
| Provider Name | Tracy Stichert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063032316 PECOS PAC ID: 2062818321 Enrollment ID: I20240610000073 |
| Provider Name | Kurtis B Pcolka |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083090534 PECOS PAC ID: 7012299944 Enrollment ID: I20240614001666 |
| Provider Name | Akua Serwaah Osei Poku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548089063 PECOS PAC ID: 9931633518 Enrollment ID: I20241106000767 |
| Provider Name | Jesse Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720873854 PECOS PAC ID: 2466970157 Enrollment ID: I20250516000709 |
Melchor Sipalay Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 Lake Ave, Pueblo, CO 81004 Phone: 719-564-0300 Fax: 719-564-0303 | |
Pueblo Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 625 N Monument Ave, Pueblo, CO 81001 Phone: 719-543-8711 Fax: 719-543-5340 | |
Digestive Diseases Specialists Of Colorado,llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1600 N Grand Ave, Suite 440, Pueblo, CO 81003 Phone: 719-543-3500 Fax: 719-543-3504 | |
Aleracare Of Colorado, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1303 Fortino Blvd, Pueblo, CO 81008 Phone: 888-209-8874 | |
American Current Care P.a . Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4117 N Elizabeth St, Pueblo, CO 81008 Phone: 719-545-0788 | |
Front Range Clinic Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1249 E Routt Ave, Pueblo, CO 81004 Phone: 720-808-0051 | |
Health Solutions Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1302 Chinook Ln, Pueblo, CO 81001 Phone: 719-545-2746 |