CHAMPIONS FAMILY MEDICAL
NPI 1700322575
Legal Medicine in Pueblo, CO
NPI Status: Active since January 17, 2017
Contact Information
415 N GRAND AVE
PUEBLO, CO
ZIP 81003
Phone: (719) 924-8448
Fax: (719) 924-9382
- Organization
- Legal Medicine
- CLIA Number: 06D2134327
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-30-2025
About CHAMPIONS FAMILY MEDICAL
This page provides the complete NPI Profile along with additional information for Champions Family Medical, a provider established in Pueblo, Colorado operating as a Legal Medicine. The healthcare provider is registered in the NPI registry with number 1700322575 assigned on January 2017. The practitioner's primary taxonomy code is 173000000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. Champions Family Medical operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Champions Family Medical. The authorized official of this NPI record is Richard B Lane (Practice Manager)
- NPI
- 1700322575
- Provider Legal Name
- CHAMPIONS FAMILY MEDICAL, PLLC
- Other Organization Name
- CHAMPIONS FAMILY MEDICAL
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 415 N GRAND AVE PUEBLO, CO 81003
- Location Phone
- (719) 924-8448
- Location Fax
- (719) 924-9382
- Mailing Address
- 415 N GRAND AVE PUEBLO, CO 81003
- Mailing Phone
- (719) 924-8448
- Mailing Fax
- (719) 924-9382
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-17-2017
- Last Update Date
- 01-17-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Legal Medicine
- Taxonomy Code
- 173000000X
- Type
- Other Service Providers
- Taxonomy Description
- The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 06D2134327
- Facility Type
- Physician Office
- Certificate Effective Date
- July 31, 2023
- Certificate Expiration Date
- July 30, 2025
- Laboratory Director
- ERICA VALDEZ
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Champions Family Medical to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for CHAMPIONS FAMILY MEDICAL
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 0 | 0 | 3 | 2 | 2 | 5 | 7 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 0 | 0 | 6 | 2 | 4 | 5 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 0 + 0 + 6 + 2 + 4 + 5 + 1 + 4 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1700322575 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1689991937 | SKIN CARE NOW PUEBLO, PLLC Organization | Legal Medicine | 415 N GRAND AVE PUEBLO, CO 81003 (719) 924-8448 |
| 1134644594 | KATHERINE R DEROSSETT NP Individual | Nurse Practitioner (Family) | 415 N GRAND AVE PUEBLO, CO 81003 (719) 924-8448 |
| 1619510815 | ERIKA J VALDEZ Individual | Nurse Practitioner (Family) | 415 N GRAND AVE PUEBLO, CO 81003 (719) 924-8448 |
| 1851198444 | PUEBLO PRIMARY CARE CLINIC Organization | Family Medicine (Adult Medicine) | 415 N GRAND AVE PUEBLO, CO 81003 (719) 250-9412 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700322575, enumerated in the NPI registry as an "organization" on January 17, 2017
The provider is located at 415 N Grand Ave Pueblo, Co 81003 and the phone number is (719) 924-8448
This medical organization specializes in Legal Medicine with taxonomy code 173000000X
The provider's CLIA number is 06D2134327 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on January 17, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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