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SOUTHERN COLORADO FAMILY MEDICINE
NPI 1710933163
Family Medicine in Pueblo, CO

Active since May 26, 2006
902 LAKEVIEW AVE, PUEBLO, CO 81004(719) 557-5855(719) 557-4652 Get Directions Write a Review

NPPES record last updated: April 22, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Southern Colorado Family Medicine NPPES

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

SOUTHERN COLORADO FAMILY MEDICINE (NPI 1710933163) is a healthcare organization registered as a family medicine in Pueblo, Colorado and active in the NPI registry since May 2006. The organization lists Angela Skinner, Oma Administrator, as its authorized official.

NPPES Registry Identity

NPI1710933163
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCATHOLIC HEALTH INITIATIVES COLORADO
Location Address902 LAKEVIEW AVEPueblo, CO 81004-3597
Mailing AddressPo Box 911057Denver, CO 80291-1057 · (303) 643-1099 · Fax (303) 643-1176
Phone(719) 557-5855
Fax(719) 557-4652
Organization SubpartNo
Authorized OfficialAngela SkinnerOma Administrator · (303) 673-7175
Enumeration DateMay 26, 2006
Last NPPES UpdateApril 22, 2016
✔ NPI 1710933163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
902 LAKEVIEW AVE, Pueblo, CO 81004
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Other Names 1

Doing Business AsSouthern Colorado Family Medicine

Other Identifiers 2

Medicare PINC260008CO
Medicaid49735578CO

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 MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southern Colorado Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateColoradoEnrollment IDO20031215000462Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

1,192

Medicare enrollment records show 1,192 clinicians reassign Medicare billing to Southern Colorado Family Medicine, which bills Medicare for the services they deliver. Of these, 17 practice at this address and 58 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 51

Nurse Practitioner206
Hospitalist177
Family Practice161
Certified Registered Nurse Anesthetist (CRNA)121
Anesthesiology75
Obstetrics/Gynecology61
General Surgery40
Internal Medicine35
43 other specialties316

Nearest to this location (20)

See all 1,192
Brenda Biggerstaff, LCSW
Clinical Social Worker
NPI 1487422713
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 250-6061
✔ PECOS✔ Accepts MedicareSame address
Nathan Culberson, MD
Family Practice
NPI 1598150963
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Leslie Dabovich, MD
Family Practice
NPI 1225349202
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
John De Villa, FNP-BC
Nurse Practitioner
NPI 1205474210
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Tiffany Garcia, FNP
Nurse Practitioner
NPI 1154203172
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Hannah Houck, DO
Family Practice
NPI 1447813241
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Ryan Jaarsma, PSY.D.
Clinical Psychologist
NPI 1679509392
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOSSame address
Grace Kim, DO
Family Practice
NPI 1235703737
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Emillia Lloyd, M.D.
Family Practice
NPI 1578630885
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Samuel Longfellow, D.O.
Family Practice
NPI 1851771943
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5872
✔ PECOS✔ Accepts MedicareSame address
Rebecka Reatherford, AGACNP-BC
Nurse Practitioner
NPI 1053895532
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Collin Roberts, DO
Family Practice
NPI 1760179014
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Jamie Roemer, MD
Hospitalist
NPI 1306401310
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Skelly, APN
Nurse Practitioner
NPI 1467737189
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Laura Stein, M.D.
Family Practice
NPI 1376549840
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Bradley Dempsey, MD
Family Practice
NPI 1164656542
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Andrea Lewis, DO
Family Practice
NPI 1720515224
902 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-5855
✔ PECOS✔ Accepts MedicareSame address
Camille Azar, M.D.
Gastroenterology
NPI 1265477046
1020 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-3660
✔ PECOS✔ Accepts Medicare0.1 mi
Gregory Mcclain, M.D.
General Surgery
NPI 1093763542
1020 LAKEVIEW AVE
Pueblo, CO 81004
(719) 557-3777
✔ PECOS✔ Accepts Medicare0.1 mi
Wendy Girard, MD
Family Practice
NPI 1750510145
1925 EAST ORMAN AVENUE SUITE A109
Pueblo, CO 81004
(719) 564-0210
✔ PECOS✔ Accepts Medicare0.1 mi
See all 1,192 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Catholic Health Initiatives Colorado's NPI number?

The NPI number for Catholic Health Initiatives Colorado is 1710933163. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is doing business as Southern Colorado Family Medicine.

Where is Catholic Health Initiatives Colorado located?

Catholic Health Initiatives Colorado is located at 902 Lakeview Ave, Pueblo, CO 81004. The listed phone number is (719) 557-5855.

What is Catholic Health Initiatives Colorado's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Catholic Health Initiatives Colorado enrolled in Medicare?

Yes. Catholic Health Initiatives Colorado is registered in the Medicare PECOS enrollment system.

When is Catholic Health Initiatives Colorado's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Colorado, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Catholic Health Initiatives Colorado?

According to the CMS Revalidation Reassignment List (October 2026 release), 1,192 clinicians in 51 Medicare specialties reassign their Medicare billing to Catholic Health Initiatives Colorado. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (206), Hospitalist (177) and Family Practice (161). Of these, 17 practice at this address and 58 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Catholic Health Initiatives Colorado was last updated on April 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.