Active NPI
Ingenious Personalized Medicine, LLC
- Clinical Medical Laboratory
- Colorado Springs, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- INGENIOUS PERSONALIZED MEDICINE, LLC
- Practice address
- 6915 Tutt Boulevard
Suite 110a
Colorado Springs, CO 80923-3591 - Phone
- (786) 221-1734
- Fax
- (305) 891-4228
- NPI assigned
- Jun 1, 2021
- Last updated
- Jan 9, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Scott Daniel Segal, MD
- Title
- Ceo
- Phone
- (888) 852-6672
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
6915 Tutt Boulevard
Suite 110a
Colorado Springs, CO 80923-3591
Mailing address
1065 NE 125TH Street
Suite 300
North Miami, FL 33161-5833
Phone (786) 221-1734
National Provider Directory
National Provider Directory- Tax ID family
- Ingenious Personalized Medicine LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Lone Tree, CO
- NPI 1982318671
-
- Clinical Medical Laboratory
- Tallahassee, FL
- NPI 1669141230
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatry Physician
- North Miami, FL
- NPI 1821086323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1673222400000",
"number": "1083280978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1065 NE 125TH STREET",
"address_2": "SUITE 300",
"city": "NORTH MIAMI",
"state": "FL",
"postal_code": "331615833",
"telephone_number": "786-221-1734",
"fax_number": "305-891-4228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6915 TUTT BOULEVARD",
"address_2": "SUITE 110A",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809233591",
"telephone_number": "786-221-1734",
"fax_number": "305-891-4228"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INGENIOUS PERSONALIZED MEDICINE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-01",
"last_updated": "2023-01-09",
"certification_date": "2023-01-09",
"status": "A",
"authorized_official_last_name": "SEGAL",
"authorized_official_first_name": "SCOTT",
"authorized_official_middle_name": "DANIEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "888-852-6672",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.