Individual provider Active NPI

Roberta Marie Thornton, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1083412472
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.1000617-NP Issued in CO
Practice address
1591 Taos Rd BLDG a
Pueblo, CO 81006-1232
Phone
(719) 423-1500
NPI assigned
Mar 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.1000617-NP CO Primary

Addresses

Primary practice location

1591 Taos Rd BLDG a
Pueblo, CO 81006-1232

Mailing address

41 Montebello Rd Ste 204
Pueblo, CO 81001-1379
Phone (719) 545-2746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805004375 CO Practitioner - Nurse Practitioner 2466960810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 E Boulder
Colorado Springs, CO 80909-5533
Phone (719) 776-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.1000617-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Sep 8, 2025 Accepting new patients
Peak Vista Community Health Centers CurrentSince Sep 8, 2025 Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

340 Printers Pkwy
Colorado Springs, CO 80910
Phone (719) 228-6635

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

Interoperability endpoints

  • Direct secure messaging: roberta.thornton.p1@direct.peakvista.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1083412472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MONTEBELLO RD STE 204",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011379",
            "telephone_number": "719-545-2746",
            "fax_number": "719-545-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 TAOS RD BLDG A",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810061232",
            "telephone_number": "719-423-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "ROBERTA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-03",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.1000617-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.