Organization Active NPI

Vaxcare Colorado LLC

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1164800082
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VAXCARE COLORADO LLC
Practice address
6005 Delmonico Dr
Suite 150
Colorado Springs, CO 80919-2237
Phone
(407) 480-5986
NPI assigned
May 12, 2015
Last updated
Jul 24, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
VAXCARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Authorized official

Name
Casey Deloach
Title
Manager
Phone
(888) 829-8550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

6005 Delmonico Dr
Suite 150
Colorado Springs, CO 80919-2237

Mailing address

800 N Magnolia Ave Ste 700
Orlando, FL 32803-3264
Phone (407) 480-5986

Other practice location 1

255 Union Blvd Ste 120
Lakewood, CO 80228-1833
Phone (888) 829-8550

Other identifiers 1

IdentifierTypeStateIssuer
PHC059OtherMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190729000677 TX Part B Supplier - Centralized Flu Biller 7719213842 Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory
Part of
Vaxcare LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1164800082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N MAGNOLIA AVE STE 700",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033264",
            "telephone_number": "407-480-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 DELMONICO DR",
            "address_2": "SUITE 150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809192237",
            "telephone_number": "407-480-5986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Union Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281833",
            "country_code": "US",
            "telephone_number": "888-829-8550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VAXCARE COLORADO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAXCARE CORPORATION",
        "enumeration_date": "2015-05-12",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "DELOACH",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "888-829-8550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "PHC059",
            "state": null
        }
    ],
    "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 Jul 24, 2026; 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.