NPIMap

Individual provider Active NPI

Karen J Seymour

  • Family Medicine Physician
  • Colo Sprgs, CO
National Provider Identifier
1033255989
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
110662 Issued in CO
Practice address
730 W Cheyenne Blvd
Suite 100
Colo Sprgs, CO 80905-2424
Phone
(719) 632-0324
Fax
(719) 955-2854
NPI assigned
Jan 29, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 110662 CO Primary

Addresses

Primary practice location

730 W Cheyenne Blvd
Suite 100
Colo Sprgs, CO 80905-2424

Mailing address

730 W Cheyenne Blvd
Suite 100
Colo Sprgs, CO 80905-2424
Phone (719) 632-0324

Other identifiers 2

IdentifierTypeStateIssuer
110662OtherCOLICENSE
26102846MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081015000414 CO Practitioner - Nurse Practitioner 5799843033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

9480 Briar Village PT
Colorado Springs, CO 80920-7922
Phone (719) 623-2101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
110662COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Feb 1, 2018 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 1, 2018 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

9480 Briar Village Pt
Ste 200
Colorado Springs, CO 80920
Phone (719) 278-3627

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1033255989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 W CHEYENNE BLVD",
            "address_2": "SUITE 100",
            "city": "COLO SPRGS",
            "state": "CO",
            "postal_code": "809052424",
            "telephone_number": "719-632-0324",
            "fax_number": "719-955-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 W CHEYENNE BLVD",
            "address_2": "SUITE 100",
            "city": "COLO SPRGS",
            "state": "CO",
            "postal_code": "809052424",
            "telephone_number": "719-632-0324",
            "fax_number": "719-955-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYMOUR",
        "first_name": "KAREN",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "110662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "110662",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26102846",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.