PUEBLO SPORTS AND FAMILY MEDICINE PLLC
NPI 1225525132
Family Medicine - Sports Medicine in Pueblo, CO

Q: What is Pueblo Sports And Family Medicine PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Active since April 16, 2018CLIA 06D2150626 · Waiver

1315 FORTINO BLVD STE C, PUEBLO, CO 81008(719) 544-2740 Get Directions Write a Review

NPPES record last updated: April 22, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Pueblo Sports And Family Medicine Pllc NPPES

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

PUEBLO SPORTS AND FAMILY MEDICINE PLLC (NPI 1225525132) is a healthcare organization registered as a sports medicine in Pueblo, Colorado and active in the NPI registry since April 2018. The organization holds a CLIA Waiver certificate valid through June 27, 2028 and lists Rakesh Khosla, President, as its authorized official.

NPPES Registry Identity

NPI1225525132

Entity TypeOrganization

Primary Taxonomy207QS0010X

Legal Business NamePUEBLO SPORTS AND FAMILY MEDICINE PLLC

Location Address1315 FORTINO BLVD STE CPueblo, CO 81008-1981

Mailing Address1315 Fortino Blvd Ste CPueblo, CO 81008-1981 · (719) 544-2740

Phone(719) 544-2740

Organization SubpartNo

Authorized OfficialRakesh KhoslaPresident · (719) 544-2740

Enumeration DateApril 16, 2018

Last NPPES UpdateApril 22, 2018

✔ NPI 1225525132 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in CO · 543004

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

1315 FORTINO BLVD STE C, Pueblo, CO 81008

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Other Identifiers 2

Medicaid1268788CO

Other0004910CO · Pa Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 06D2150626

Pueblo Sports And Family Medicine, PLLC · Pueblo, CO

Active · expires Jun 27, 2028

CLIA Number06D2150626

Laboratory TypePhysician Office

Certificate Effective DateJune 28, 2026

Certificate Expiration DateJune 27, 2028

Laboratory DirectorDr. Rakesh K. Khosla

Laboratory Phone(719) 544-2740

Laboratory LocationPueblo Sports And Family Medicine, PLLC1315 Fortino Blvd Suite C, Pueblo, CO 81008

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

JOSEY SCHNAUFER PA-C

Physician Assistant

1315 FORTINO BLVD STE C
PUEBLO, CO 81008

Pueblo County (719) 544-2740

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 Pueblo Sports And Family Medicine PLLC's NPI number?

The NPI number for Pueblo Sports And Family Medicine PLLC is 1225525132. It was assigned to this organization in the NPPES registry on April 16, 2018.

Where is Pueblo Sports And Family Medicine PLLC located?

Pueblo Sports And Family Medicine PLLC is located at 1315 Fortino Blvd Ste C, Pueblo, CO 81008. The listed phone number is (719) 544-2740.

What is Pueblo Sports And Family Medicine PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Does Pueblo Sports And Family Medicine PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D2150626) is associated with this NPI, valid through June 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pueblo Sports And Family Medicine PLLC was last updated on April 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.