Southern Colorado Clinic Pc - Medicare Primary Care in Pueblo, CO

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Southern Colorado Clinic Pc is a medicare enrolled primary clinic (Clinic/center) in Pueblo, Colorado. The current practice location for Southern Colorado Clinic Pc is 3676 Parker Blvd, Pueblo, Colorado. For appointments, you can reach them via phone at (719) 553-2200. The mailing address for Southern Colorado Clinic Pc is Po Box 9000, Pueblo, Colorado and phone number is (719) 553-2200.

Southern Colorado Clinic Pc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1285613554. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (719) 553-2200.

Contact Information

Southern Colorado Clinic Pc
3676 Parker Blvd
Pueblo
CO 81008-2212
(719) 553-2200
(719) 553-2213

Map and Direction


Primary Care Clinic Profile

Full NameSouthern Colorado Clinic Pc
SpecialityClinic/Center
Location3676 Parker Blvd, Pueblo, Colorado
Authorized Official Name and PositionJennifer Arellano (COO)
Authorized Official Contact7195531801
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice 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 Details:

NPI Number1285613554
Provider Enumeration Date01/13/2006
Last Update Date12/05/2022

Medicare PECOS Information:

Medicare PECOS PAC ID4284524067
Medicare Enrollment IDO20040316001277

Medical Identifiers

Medical identifiers for Southern Colorado Clinic Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1285613554NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Southern Colorado Clinic Pc acts as a billing entity for following providers:
Provider NameDwight K Caughfield
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1235102096
PECOS PAC ID: 3779477294
Enrollment ID: I20040213000275
Provider NameRochelle Y. Elijah
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1376504654
PECOS PAC ID: 1355254541
Enrollment ID: I20040622000169
Provider NameCheryl A Cavalli
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1306841325
PECOS PAC ID: 0446212856
Enrollment ID: I20041028000554
Provider NameScott A De Ruiter
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1093777658
PECOS PAC ID: 9739137266
Enrollment ID: I20050111000642
Provider NameStephen G Vialpando
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1396772778
PECOS PAC ID: 2567495237
Enrollment ID: I20050913001251
Provider NameShannon L Snow
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1508818428
PECOS PAC ID: 3072529163
Enrollment ID: I20060227000617
Provider NameMerilee C Briggs Mead
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710936968
PECOS PAC ID: 3072525070
Enrollment ID: I20060609000237
Provider NameSteven J Simerville
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1497712921
PECOS PAC ID: 7012955354
Enrollment ID: I20060613000326
Provider NameRalph L Bidwell
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1306966221
PECOS PAC ID: 6406940642
Enrollment ID: I20070919000692
Provider NameJohn G Beauman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1497722441
PECOS PAC ID: 4587752753
Enrollment ID: I20080604000471
Provider NameLisa A Clough
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841459690
PECOS PAC ID: 8224104799
Enrollment ID: I20080906000187
Provider NameSergio Alberto Murillo Herrera
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1598923757
PECOS PAC ID: 3870653348
Enrollment ID: I20081114000371
Provider NamePatrick K Timms
Provider TypePractitioner - Rheumatology
Provider IdentifiersNPI Number: 1861455099
PECOS PAC ID: 7315837119
Enrollment ID: I20091030000138
Provider NameJaymie R Ownbey
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1962735985
PECOS PAC ID: 8820285943
Enrollment ID: I20101214001334
Provider NameKaren Springfield
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760766430
PECOS PAC ID: 4789628074
Enrollment ID: I20120127000653
Provider NameMallikarjuna Nallegowda
Provider TypePractitioner - Pain Management
Provider IdentifiersNPI Number: 1770733743
PECOS PAC ID: 9436391539
Enrollment ID: I20130819000660
Provider NameAaron M Fields
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1922061522
PECOS PAC ID: 9436162005
Enrollment ID: I20131017001195
Provider NameWendy Rene Archuleta
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538564810
PECOS PAC ID: 6406171545
Enrollment ID: I20150211001618
Provider NameJodi R Trujillo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972050615
PECOS PAC ID: 7113208844
Enrollment ID: I20170111001851
Provider NameHarry J Aragon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366959363
PECOS PAC ID: 8426317710
Enrollment ID: I20180112000058
Provider NameTarah K Sellner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659865533
PECOS PAC ID: 8527316660
Enrollment ID: I20180806001029
Provider NameJulie Esther Ayaad
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710524137
PECOS PAC ID: 4981031614
Enrollment ID: I20200219000705
Provider NameLaura L Martin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598304438
PECOS PAC ID: 2567899917
Enrollment ID: I20200224002150
Provider NameHavilah R Spurlock
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023658713
PECOS PAC ID: 6507297611
Enrollment ID: I20200505001896
Provider NameBrandi L Trujillo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902435506
PECOS PAC ID: 1951732569
Enrollment ID: I20200515000421
Provider NameJessica M Anaya
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255945960
PECOS PAC ID: 7113345356
Enrollment ID: I20200921000460
Provider NameLindsay M Sweetman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932708013
PECOS PAC ID: 6608287578
Enrollment ID: I20201125000223
Provider NameCarla E Paredes Diaz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932708872
PECOS PAC ID: 4385056977
Enrollment ID: I20201228000427
Provider NameThomas J Centi
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1588993828
PECOS PAC ID: 0042613275
Enrollment ID: I20210727000213
Provider NameAngela Marie Perides
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972024453
PECOS PAC ID: 0547532756
Enrollment ID: I20220121002322
Provider NameMonica Lyn Valdez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225423981
PECOS PAC ID: 9436541232
Enrollment ID: I20220127001078
Provider NameChristina Oldfield
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649901000
PECOS PAC ID: 9032594361
Enrollment ID: I20220922000652
Provider NamePaul Oldfield
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396479010
PECOS PAC ID: 1759767940
Enrollment ID: I20220926000517
Provider NameHannah Marie Schmitt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497462048
PECOS PAC ID: 4284005224
Enrollment ID: I20230130001329
Provider NameBethany Lynne Daniel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336853266
PECOS PAC ID: 8325410806
Enrollment ID: I20230209001247
Provider NameRachel Elizabeth Whitten
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104424795
PECOS PAC ID: 4587078878
Enrollment ID: I20230718004332
Provider NameDanielle Marie Kizzie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780460592
PECOS PAC ID: 3476909839
Enrollment ID: I20231023000415
Provider NameQueenter M Kisang
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1033773627
PECOS PAC ID: 9335473578
Enrollment ID: I20231218002419
Provider NameJulia Grace Moore
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1417712423
PECOS PAC ID: 8224477179
Enrollment ID: I20240411004047
Provider NameKellie Ann Jakubowicz
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1225884976
PECOS PAC ID: 6901247253
Enrollment ID: I20240516004181
Provider NameTracy Stichert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063032316
PECOS PAC ID: 2062818321
Enrollment ID: I20240610000073
Provider NameKurtis B Pcolka
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1083090534
PECOS PAC ID: 7012299944
Enrollment ID: I20240614001666

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.