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UROLOGY OF SOUTHERN COLORADO PLLC
NPI 1104001379
Clinic/Center - Medical Specialty in Pueblo, CO

Active since January 07, 2008
3676 PARKER BLVD, SUITE 310, PUEBLO, CO 81008(719) 545-1500 Get Directions Write a Review

NPPES record last updated: October 15, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Urology Of Southern Colorado Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UROLOGY OF SOUTHERN COLORADO PLLC (NPI 1104001379) is a healthcare organization registered as a medical specialty in Pueblo, Colorado and active in the NPI registry since January 2008. The organization lists Dana Joan Weaver-osterholtz, Owner, as its authorized official.

NPPES Registry Identity

NPI1104001379
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameUROLOGY OF SOUTHERN COLORADO PLLC
Location Address3676 PARKER BLVD, SUITE 310Pueblo, CO 81008-2212
Mailing Address3676 Parker Blvd, Suite 310Pueblo, CO 81008-2212 · (719) 545-1500
Phone(719) 545-1500
Organization SubpartNo
Authorized OfficialDana Joan Weaver-osterholtzOwner · (719) 676-3728
Enumeration DateJanuary 7, 2008
Last NPPES UpdateOctober 15, 2009
✔ NPI 1104001379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in CO · 40134
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
3676 PARKER BLVD, Pueblo, CO 81008
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Other Identifiers 3

Medicare PIN365248CO
Medicaid48477877CO
Medicare UPINA13718CO

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. RITA ANN ELLSWORTH MD
Pediatrics
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2200
MS. MARSHA R FLOWERS OTC
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2206
HAVILAH R. SPURLOCK FNP-C
Nurse Practitioner (Family)
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2200
JENNIFER LIVINGSTON
Nurse Practitioner (Family)
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2200
DR. QUEENTER KISANG MD
Family Medicine
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-1804
MISS CARLA RAE PROCTOR M.D.
Pediatrics
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2204
MR. RYAN SCOTT ESLINGER OTC
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2200
MS. RACHEL ELIZABETH WHITTEN MSN, APRN, FNP
Nurse Practitioner (Family)
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Urology Of Southern Colorado PLLC's NPI number?

The NPI number for Urology Of Southern Colorado PLLC is 1104001379. It was assigned to this organization in the NPPES registry on January 7, 2008.

Where is Urology Of Southern Colorado PLLC located?

Urology Of Southern Colorado PLLC is located at 3676 Parker Blvd Suite 310, Pueblo, CO 81008. The listed phone number is (719) 545-1500.

What is Urology Of Southern Colorado PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Urology Of Southern Colorado PLLC was last updated on October 15, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.