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Individual provider Active NPI

Bryce Callister, DO

  • Psychiatry Physician
  • Colorado Springs, CO
National Provider Identifier
1194952861
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DR.0053429 Issued in CO
Practice address
115 S Parkside Drive
Colorado Springs, CO 80910
Phone
(719) 572-6100
Fax
(719) 447-4740
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DR.0053429 CO Primary
Student in an Organized Health Care Education/Training Program 390200000X OT012962 PA

Addresses

Primary practice location

115 S Parkside Drive
Colorado Springs, CO 80910

Mailing address

220 Ruskin Drive
Colorado Springs, CO 80910
Phone (719) 572-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141010000720 CO Practitioner - PsychiatryPractitioner - Family Practice 4284854456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2450 S Peoria
Suite 248 Virtual Behavioral Health Center
Aurora, CO 80014-5475
Phone (833) 701-0448

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT012962PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince May 17, 2022 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince May 17, 2022 Accepting new patients
Cedar Springs Hospital, Inc CurrentSince Nov 15, 2019 Accepting new patients
Cedar Springs Hospital, Inc Family Medicine CurrentSince Nov 15, 2019 Accepting new patients

Locations

2450 S Peoria St
Ste 248
Aurora, CO 80014
Phone (303) 752-7747

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

2135 Southgate Rd
Colorado Springs, CO 80906
Phone (719) 329-5353

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1455 Main St
Ste 100
Windsor, CO 80550
Phone (970) 207-4857

1455 Main St
Ste 140
Windsor, CO 80550
Phone (970) 460-9205

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 and National Provider Directory roles.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1194952861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RUSKIN DRIVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80910",
            "telephone_number": "719-572-6100",
            "fax_number": "719-447-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S PARKSIDE DRIVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80910",
            "telephone_number": "719-572-6100",
            "fax_number": "719-447-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLISTER",
        "first_name": "BRYCE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0053429",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT012962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.