Individual provider Active NPI

Jordan Bevans, PA

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1093433104
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1725 E Boulder St Ste 101
Colorado Springs, CO 80909-5740
Phone
(719) 365-6300
NPI assigned
Aug 16, 2022
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1725 E Boulder St Ste 101
Colorado Springs, CO 80909-5740

Mailing address

1725 E Boulder St Ste 101
Colorado Springs, CO 80909-5740

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
I20260311000028 CO Practitioner - Physician Assistant 8022591882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1725 E Boulder St
Suite 101 Uchmg Neurosciences Colorado S
Colorado Springs, CO 80909-5740
Phone (719) 365-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Mar 3, 2026 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Mar 3, 2026 Accepting new patients

Locations

1725 E Boulder St
Ste 101
Colorado Springs, CO 80909
Phone (719) 365-6300

16222 W US Highway 24
Ste 220
Woodland Park, CO 80863
Phone (719) 365-7300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1093433104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E BOULDER ST STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E BOULDER ST STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095740",
            "telephone_number": "719-365-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVANS",
        "first_name": "JORDAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.