Organization Active NPI

Scot F. Sickbert, M.D., LLC

  • Internal Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1124216940
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25001 Issued in CO
Legal business name
SCOT F. SICKBERT, M.D., LLC
Practice address
325 Parkside Dr
Colorado Springs, CO 80910-3134
Phone
(719) 761-0397
Fax
(719) 473-7475
NPI assigned
Oct 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Dr. Scot Francis Sickbert, M.D.
Title
Physician
Phone
(719) 761-0397

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25001 CO Primary

Addresses

Primary practice location

325 Parkside Dr
Colorado Springs, CO 80910-3134

Mailing address

325 Parkside Dr
Colorado Springs, CO 80910-3134
Phone (719) 761-0397

Other identifiers 1

IdentifierTypeStateIssuer
68902573MedicaidCO

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": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1124216940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PARKSIDE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103134",
            "telephone_number": "719-761-0397",
            "fax_number": "719-473-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PARKSIDE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103134",
            "telephone_number": "719-761-0397",
            "fax_number": "719-473-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOT F. SICKBERT, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "SICKBERT",
        "authorized_official_first_name": "SCOT",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "719-761-0397",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "25001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68902573",
            "state": "CO"
        }
    ],
    "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 Oct 5, 2007; 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.