Active NPI
Richard James Kouri, M.D.
- Pediatrics Physician
- Colorado Springs, CO
National Provider Identifier
1164419677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20619
- Practice address
- 1715 N Weber St Ste 120
Colorado Springs, CO 80907-7524 - Phone
- (719) 577-4200
- Fax
- (719) 442-6595
- NPI assigned
- Sep 29, 2005
- Last updated
- Oct 17, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20619 | CO | Primary |
Addresses
Primary practice location
1715 N Weber St Ste 120
Colorado Springs, CO 80907-7524
Mailing address
1715 N Weber St Ste 120
Colorado Springs, CO 80907-7524
Phone (719) 577-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01206192 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20619 | CO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Are Great Pediatrics | Past | Accepting new patients | |
| A Glenn Shoptaugh MD PC | Pediatrics | Past | Accepting new patients |
| Uch-MHS | Past | Accepting new patients | |
| Memorial Health System | Pediatrics | Past | Accepting new patients |
Organizations & group practices 4
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.
-
dba Kids Are Great Pediatrics
- Pediatrics Physician
- Colorado Springs, CO
- NPI 1285877183
-
- Primary Care Clinic/Center
- Colorado Springs, CO
- NPI 1013465327
-
dba Memorial Hospital Phys Group
- General Acute Care Hospital
- Colorado Springs, CO
- NPI 1568668754
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350432000000",
"number": "1164419677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 N WEBER ST STE 120",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809077524",
"telephone_number": "719-577-4200",
"fax_number": "719-442-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 N WEBER ST STE 120",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809077524",
"telephone_number": "719-577-4200",
"fax_number": "719-442-6595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOURI",
"first_name": "RICHARD",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2012-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CO",
"license": "20619",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01206192",
"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 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.