Organization Active NPI

Pikes Peak Family Medicine

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1114742046
Registry record updated Dec 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PIKES PEAK FAMILY MEDICINE
Practice address
1755 Telstar Dr Ste 300
Colorado Springs, CO 80920-1019
Phone
(719) 401-3626
Fax
(719) 749-3022
NPI assigned
Nov 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2025

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

Authorized official

Name
Michelle Elizabeth EastonNPI 1043692734
Title
Owner
Phone
(719) 401-3626

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1755 Telstar Dr Ste 300
Colorado Springs, CO 80920-1019

Mailing address

1755 Telstar Dr Ste 300
Colorado Springs, CO 80920-1019
Phone (719) 401-3626

Other names 1

  • Haven Health & Wellness Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250124000319 CO Part B Supplier - Clinic/Group Practice 0345779096 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

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": "1731628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766188800000",
    "number": "1114742046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 TELSTAR DR STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201019",
            "telephone_number": "719-401-3626",
            "fax_number": "719-749-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 TELSTAR DR STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201019",
            "telephone_number": "719-401-3626",
            "fax_number": "719-749-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKES PEAK FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-15",
        "last_updated": "2025-12-20",
        "certification_date": "2025-12-20",
        "status": "A",
        "authorized_official_last_name": "EASTON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-401-3626"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haven Health & Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Dec 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.