Organization Active NPI

Peak Medical Colorado No. 2, LLC

  • Skilled Nursing Facility
  • Colorado Springs, CO
National Provider Identifier
1104870542
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0818 Issued in CO
Legal business name
PEAK MEDICAL COLORADO NO. 2, LLC
Practice address
835 Tenderfoot Hill Rd
Colorado Springs, CO 80906-3903
Phone
(719) 576-8380
Fax
(719) 576-5691
NPI assigned
May 20, 2006
Organization subpart
Yes
Parent organization
SUNBRIDGE HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Authorized official

Name
Michael T Berg
Title
Auth Official
Phone
(505) 468-4742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0818 CO Primary

Addresses

Primary practice location

835 Tenderfoot Hill Rd
Colorado Springs, CO 80906-3903

Mailing address

101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604

Other identifiers 1

IdentifierTypeStateIssuer
75951274MedicaidCO

Other names 1

  • Cheyenne Mountain Care and Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Part of
Terrace Hghts Nursing H

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1104870542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 TENDERFOOT HILL RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063903",
            "telephone_number": "719-576-8380",
            "fax_number": "719-576-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK MEDICAL COLORADO NO. 2, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE LLC",
        "enumeration_date": "2006-05-20",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "AUTH OFFICIAL",
        "authorized_official_telephone_number": "505-468-4742"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "0818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75951274",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cheyenne Mountain Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cheyenne Mountain Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.