Individual provider Active NPI

Leah Thompson, NP

  • Nurse Practitioner
  • Canon City, CO
National Provider Identifier
1164146734
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0998021-NP Issued in CO
Practice address
113 Latigo LN Ste D
Canon City, CO 81212-8115
Phone
(719) 371-0000
NPI assigned
Sep 28, 2022
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0998021-NP CO Primary

Addresses

Primary practice location

113 Latigo LN Ste D
Canon City, CO 81212-8115

Mailing address

PO Box 1868
Canon City, CO 81215-1868
Phone (719) 371-0000

Other practice location 1

2140 Hollow Brook Dr Ste 110
Colorado Springs, CO 80918-1489
Phone (719) 285-3420

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
I20230131001876 CO Practitioner - Nurse Practitioner 8224409123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metamorphosis LTDGroup PAC ID 1456573427, 5 clinicians

Practice addresses (Care Compare)

113 Latigo LN
Suite D
Canon City, CO 81212-8115
Phone (719) 371-0000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metamorphosis LTD CurrentSince Oct 20, 2022 Accepting new patients
Metamorphosis LTD Nurse Practitioner Past Accepting new patients

Locations

113 Latigo Ln
Ste D
Canon City, CO 81212
Phone (719) 371-0000

2140 Hollow Brook Dr
Ste 110
Colorado Springs, CO 80918
Phone (719) 371-0000

6015 Lehman Dr
Ste 205
Colorado Springs, CO 80918
Phone (719) 296-4180

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": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1164146734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1868",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812151868",
            "telephone_number": "719-371-0000",
            "fax_number": "888-965-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 LATIGO LN STE D",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128115",
            "telephone_number": "719-371-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2140 Hollow Brook Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809181489",
            "country_code": "US",
            "telephone_number": "719-285-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LEAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0998021-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.