Phillip Audra Shriver, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

42075 Issued in CO

Practice address

2880 International Cir # N010
Colorado Springs, CO 80910-3127

Phone

(719) 520-7080

Fax

(719) 520-7086

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1928/brand/1/csg/62/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premise Health of Colorado Medical PC

  • Primary Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1497990287
  Medicare reassignment NPD
• Premise Health of Colorado Medical PC

  • Primary Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1992940951
  NPD
• Mountain View Medical Group, PC

  • Durable Medical Equipment & Medical Supplies
  • Colorado Springs, CO
  • NPI 1144405200
  NPD (past)
• Mountain View Medical Group, PC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1295787703
  NPD (past)
• Texas Tech University Health Sciences Center University Associates

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1902832181
  NPD (past)
• Umc Physicians

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1669418547
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1164564928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 PRINTERS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103190",
            "telephone_number": "719-632-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 INTERNATIONAL CIR # N010",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103127",
            "telephone_number": "719-520-7080",
            "fax_number": "719-520-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIVER",
        "first_name": "PHILLIP",
        "middle_name": "AUDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "42075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35001577",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William R Shreck, O.D.
• Srijana Shrestha
• Vinu Shrestha, MD
• Yogesh Shrestha, MD
• Deanna M Shrewsbury, LPC , ATR-BC
• Ryan Shroyer, MT
• Stephanie Shubert, LMFT
• Jalea K Shuff
• Richard David Shuger, MD
• Laura M Shughart, LCSW

• Family Medicine Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.