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SANGRE DE CRISTO FAMILY PRACTICE ASSOC., P.C.
NPI 1962536326
Clinic/Center - Primary Care in Canon City, CO

Active since March 15, 2007
712 MACON AVE, CANON CITY, CO 81212(719) 275-8646(888) 484-0223 Get Directions Write a Review

NPPES record last updated: January 5, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sangre De Cristo Family Practice Assoc., P.c. NPPES

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

SANGRE DE CRISTO FAMILY PRACTICE ASSOC., P.C. (NPI 1962536326) is a healthcare organization registered as a primary care in Canon City, Colorado and active in the NPI registry since March 2007. The organization lists Michael Wayne Banker, President, as its authorized official.

NPPES Registry Identity

NPI1962536326
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSANGRE DE CRISTO FAMILY PRACTICE ASSOC., P.C.
Location Address712 MACON AVECanon City, CO 81212-3314
Mailing Address712 Macon AveCanon City, CO 81212-3314 · (719) 275-8646 · Fax (888) 484-0223
Phone(719) 275-8646
Fax(888) 484-0223
Organization SubpartNo
Authorized OfficialMichael Wayne BankerPresident · (719) 275-8646
Enumeration DateMarch 15, 2007
Last NPPES UpdateJanuary 5, 2016
✔ NPI 1962536326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in CO · 27050
712 MACON AVE, Canon City, CO 81212
Open in Google Maps ↗

Other Identifiers 2

Medicaid04119046CO
Medicare ID-Type UnspecifiedC11904CO

Other Providers at the Same Location NPPES

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

DR. MICHAEL WAYNE BANKER M.D.
Family Medicine
712 MACON AVE
CANON CITY, CO 81212
Fremont County (719) 275-8646

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 Sangre De Cristo Family Practice Assoc., P.C.'s NPI number?

The NPI number for Sangre De Cristo Family Practice Assoc., P.C. is 1962536326. It was assigned to this organization in the NPPES registry on March 15, 2007.

Where is Sangre De Cristo Family Practice Assoc., P.C. located?

Sangre De Cristo Family Practice Assoc., P.C. is located at 712 Macon Ave, Canon City, CO 81212. The listed phone number is (719) 275-8646.

What is Sangre De Cristo Family Practice Assoc., P.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Sangre De Cristo Family Practice Assoc., P.C. was last updated on January 5, 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.