Organization Active NPI

Karen K Underwood PHD LLC

  • Assisted Living Facility (Mental Illness)
  • Colorado Springs, CO
National Provider Identifier
1043379498
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
1820 Issued in CO
Legal business name
KAREN K UNDERWOOD PHD LLC
Practice address
2815 N Chelton Rd
Colorado Springs, CO 80909-1009
Phone
(719) 338-7228
Fax
(719) 630-1997
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Authorized official

Name
Dr. Karen K Underwood, PHDNPI 1124235726
Title
Psychologist
Phone
(719) 338-7228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 1820 CO
Assisted Living Facility (Mental Illness) 3104A0625X 1820 CO Primary
Skilled Nursing Facility 314000000X 1820 CO

Addresses

Primary practice location

2815 N Chelton Rd
Colorado Springs, CO 80909-1009

Mailing address

2815 N Chelton Rd
Colorado Springs, CO 80909-1009
Phone (719) 474-7425

Other identifiers 1

IdentifierTypeStateIssuer
07182025MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070719000770 CO Part B Supplier - Clinic/Group Practice 6901907062 Receives reassigned benefits from 2 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

3625 Parkmoor Village Dr
Colorado Springs, CO 80917
Phone (719) 550-0200

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1043379498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 N CHELTON RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091009",
            "telephone_number": "719-474-7425",
            "fax_number": "719-630-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 N CHELTON RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091009",
            "telephone_number": "719-338-7228",
            "fax_number": "719-630-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN K UNDERWOOD PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "719-338-7228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "CO",
            "license": "1820",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "CO",
            "license": "1820",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "1820",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07182025",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.