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COLORADO DEPARTMENT OF CORRECTIONS
NPI 1669530192
Clinic/Center - Prison Health in Pueblo, CO

Active since December 05, 2006
1410 W 13TH ST, PUEBLO, CO 81003(719) 583-5550(719) 583-5560 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 24, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Colorado Department Of Corrections NPPES

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

COLORADO DEPARTMENT OF CORRECTIONS (NPI 1669530192) is a healthcare organization registered as a prison health in Pueblo, Colorado and active in the NPI registry since December 2006. The organization lists Randolph Maul, Chief Medical Officer, as its authorized official.

NPPES Registry Identity

NPI1669530192
Entity TypeOrganization
Primary Taxonomy261QP2400X
Legal Business NameCOLORADO DEPARTMENT OF CORRECTIONS
Location Address1410 W 13TH STPueblo, CO 81003-1961
Mailing AddressPo Box 3, Sccf MedicalPueblo, CO 81002 · (719) 583-5550 · Fax (719) 583-5560
Phone(719) 583-5550
Fax(719) 583-5560
Organization SubpartYesParent: State Of Colorado
Authorized OfficialRandolph MaulChief Medical Officer · (719) 306-2821
Enumeration DateDecember 5, 2006
Last NPPES UpdateJune 24, 20252 updates tracked since enumeration
NPPES CertifiedJune 24, 2025
✔ NPI 1669530192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Prison HealthAmbulatory Health Care Facilities
Taxonomy Code261QP2400X
License✔ Licensed in CO · 391
1410 W 13TH ST, Pueblo, CO 81003
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Other Names 1

Other NameSan Carlos Correctional Facility

Other Providers at the Same Location NPPES 4

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

LAURA IMM
Social Worker (Clinical)
1410 W 13TH ST
PUEBLO, CO 81003
Pueblo County (719) 458-4654
COLORADO DEPARTMENT OF CORRECTIONS
Exclusive Provider Organization
1410 W 13TH ST
PUEBLO, CO 81003
Pueblo County (719) 583-5550
DR. JOAN KOPRIVNIKAR M.D.
Psychiatry & Neurology (Forensic Psychiatry)
1410 W 13TH ST
PUEBLO, CO 81003
Pueblo County (719) 583-5540
DR. JOSEPH JOHN WERMERS M.D.
General Practice
1410 W 13TH ST
PUEBLO, CO 81003
Pueblo County (719) 583-5550

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 Colorado Department Of Corrections's NPI number?

The NPI number for Colorado Department Of Corrections is 1669530192. It was assigned to this organization in the NPPES registry on December 5, 2006. The provider is also known as San Carlos Correctional Facility.

Where is Colorado Department Of Corrections located?

Colorado Department Of Corrections is located at 1410 W 13th St, Pueblo, CO 81003. The listed phone number is (719) 583-5550.

What is Colorado Department Of Corrections's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Prison Health, with taxonomy code 261QP2400X.

When was this NPI record last updated?

The NPPES record for Colorado Department Of Corrections was last updated on June 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.