Organization Active NPI

Peak Therapeutic Inc

  • Counseling Psychologist
  • Colorado Springs, CO
National Provider Identifier
1053896415
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
PEAK THERAPEUTIC INC
Practice address
6760 Corporate Dr Ste 140
Colorado Springs, CO 80919-5910
Phone
(951) 837-3722
Fax
(719) 631-0720
NPI assigned
Oct 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Kevin Richard BogstadNPI 1124193180
Title
Owner
Phone
(951) 837-3722

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

6760 Corporate Dr Ste 140
Colorado Springs, CO 80919-5910

Mailing address

6760 Corporate Dr Ste 140
Colorado Springs, CO 80919-5910
Phone (951) 837-3722

Other identifiers 1

IdentifierTypeStateIssuer
9000155112MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221014001927 CO Part B Supplier - Clinic/Group Practice 8224404371 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

6760 Corporate Dr
Ste 140
Colorado Springs, CO 80919
Phone (719) 270-0085

Practitioners & affiliated clinicians

Practitioners 3

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": "1538352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1053896415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6760 CORPORATE DR STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809195910",
            "telephone_number": "951-837-3722",
            "fax_number": "719-631-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6760 CORPORATE DR STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809195910",
            "telephone_number": "951-837-3722",
            "fax_number": "719-631-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK THERAPEUTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-01",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "BOGSTAD",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-837-3722"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000155112",
            "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 21, 2022; 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.