NPIMap

Organization Active NPI

The Little Clinic of Colorado LLC

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1043817844
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
THE LITTLE CLINIC OF COLORADO LLC
Practice address
3620 Austin Bluffs Pkwy
Colorado Springs, CO 80918-6631
Phone
(719) 325-0342
Fax
(719) 325-0343
NPI assigned
Oct 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Thomas Shelly
Title
VP & General Manager
Phone
(615) 425-4200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3620 Austin Bluffs Pkwy
Colorado Springs, CO 80918-6631

Mailing address

PO Box 932958
Cleveland, OH 44193-0028

Other identifiers 1

IdentifierTypeStateIssuer
9000165174MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
The Little Clinic of Colorado LLC19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1043817844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809186631",
            "telephone_number": "719-325-0342",
            "fax_number": "719-325-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LITTLE CLINIC OF COLORADO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "SHELLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VP & GENERAL MANAGER",
        "authorized_official_telephone_number": "615-425-4200"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000165174",
            "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 Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.