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CHILDREN'S CLINIC OF PUEBLO, PC
NPI 1962553172
Pediatrics in Pueblo, CO

Active since January 15, 2007CLIA 06D0967615 · Waiver
1600 N GRAND AVE, SUITE 240, PUEBLO, CO 81003(719) 295-2305(719) 295-2320 Get Directions Write a Review

NPPES record last updated: December 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Children's Clinic Of Pueblo, Pc NPPES

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

CHILDREN'S CLINIC OF PUEBLO, PC (NPI 1962553172) is a healthcare organization registered as a pediatrics in Pueblo, Colorado and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through November 16, 2027 and lists Loraine L. Carroll, Physician, as its authorized official.

NPPES Registry Identity

NPI1962553172
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameCHILDREN'S CLINIC OF PUEBLO, PC
Location Address1600 N GRAND AVE, SUITE 240Pueblo, CO 81003-2700
Mailing Address1600 N Grand Ave, Suite 240Pueblo, CO 81003-2700 · (719) 295-2305 · Fax (719) 295-2320
Phone(719) 295-2305
Fax(719) 295-2320
Organization SubpartNo
Authorized OfficialLoraine L. CarrollPhysician · (719) 295-2305
Enumeration DateJanuary 15, 2007
Last NPPES UpdateDecember 9, 2011
✔ NPI 1962553172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CO · 36942
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1600 N GRAND AVE, Pueblo, CO 81003
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Other Identifiers 2

Medicaid49708864CO
OtherCH636086Bcbs

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

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 06D0967615

Children's Clinic Of Pueblo PC · Pueblo, CO
Active · expires Nov 16, 2027
CLIA Number06D0967615
Laboratory TypePhysician Office
Certificate Effective DateNovember 17, 2025
Certificate Expiration DateNovember 16, 2027
Laboratory DirectorLoraine L. Carroll
Laboratory Phone(719) 999-4444
Laboratory LocationChildren's Clinic Of Pueblo PC1600 N Grand Ave, Pueblo, CO 81003
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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.

DR. LAUREL ELIZABETH WRIGHT M.D.
Obstetrics & Gynecology
1600 N GRAND AVE, SUITE 400
PUEBLO, CO 81003
Pueblo County (719) 543-4000
GREG ALAN BOWMAN MD
Internal Medicine (Cardiovascular Disease)
1600 N GRAND AVE, SUITE 500
PUEBLO, CO 81003
Pueblo County (719) 545-0663
DIGESTIVE DISEASES SPECIALISTS OF COLORADO,LLC
Internal Medicine (Gastroenterology)
1600 N GRAND AVE, SUITE 440
PUEBLO, CO 81003
Pueblo County (719) 543-3500
GARY GENE WOFFORD M.D.
Exclusive Provider Organization
1600 N GRAND AVE, #230
PUEBLO, CO 81003
Pueblo County (719) 562-1000
ASHAKIRAN J. SUNKU, M.D., LLC
Psychiatry & Neurology (Neurology)
1600 N GRAND AVE, SUITE: 110
PUEBLO, CO 81003
Pueblo County (719) 546-9500
MICHAEL LEE KING M.D.
Surgery
1600 N GRAND AVE, STE 510
PUEBLO, CO 81003
Pueblo County (719) 566-3535
KYLEE PROVOST DNP
Nurse Practitioner
1600 N GRAND AVE
PUEBLO, CO 81003
Pueblo County (719) 546-2500
SANGRE DE CRISTO INTERNAL MEDICINE ASSOCIATES
Internal Medicine
1600 N GRAND AVE
PUEBLO, CO 81003
Pueblo County (719) 542-3100

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 Children's Clinic Of Pueblo, PC's NPI number?

The NPI number for Children's Clinic Of Pueblo, PC is 1962553172. It was assigned to this organization in the NPPES registry on January 15, 2007.

Where is Children's Clinic Of Pueblo, PC located?

Children's Clinic Of Pueblo, PC is located at 1600 N Grand Ave Suite 240, Pueblo, CO 81003. The listed phone number is (719) 295-2305.

What is Children's Clinic Of Pueblo, PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Children's Clinic Of Pueblo, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D0967615) is associated with this NPI, valid through November 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Children's Clinic Of Pueblo, PC was last updated on December 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.