Organization Active NPI

Colorado Integrative Wellness LLC

  • Women's Health Nurse Practitioner
  • Castle Rock, CO
National Provider Identifier
1083201198
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
Legal business name
COLORADO INTEGRATIVE WELLNESS LLC
Practice address
1175 S Perry St Ste 250
Castle Rock, CO 80104-0017
Phone
(303) 862-8061
Fax
(720) 676-1411
NPI assigned
Dec 22, 2020
Organization subpart
Yes
Parent organization
COLORADO INTEGRATIVE HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Authorized official

Name
Clarissa Alumbaugh, NPNPI 1922334937
Title
Owner
Phone
(303) 862-8061

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083B0002X
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X Primary

Addresses

Primary practice location

1175 S Perry St Ste 250
Castle Rock, CO 80104-0017

Mailing address

1175 S Perry St Ste 250
Castle Rock, CO 80104-0017
Phone (303) 862-8061

Other identifiers 1

IdentifierTypeStateIssuer
84625562MedicaidCO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2276579Colorado Integrative Wellness1175 S Perry St, Suite 250, Castle Rock, CO 80104Provider-performed microscopyFeb 9, 2027

National Provider Directory

National Provider Directory
Part of
Colorado Integrative Healthcare LLC

Practitioners & affiliated clinicians

Practitioners 1

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": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1083201198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 S PERRY ST STE 250",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801040017",
            "telephone_number": "303-862-8061",
            "fax_number": "720-676-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 S PERRY ST STE 250",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801040017",
            "telephone_number": "303-862-8061",
            "fax_number": "720-676-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO INTEGRATIVE WELLNESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO INTEGRATIVE HEALTHCARE LLC",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "ALUMBAUGH",
        "authorized_official_first_name": "CLARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-862-8061",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84625562",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.