Individual provider Active NPI

Nancy Prantl, FNP-BC

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1205203098
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0991893-NP Issued in CO
Practice address
410 Gold Pass HTS
Colorado Springs, CO 80906-3882
Phone
(719) 632-5700
Fax
(719) 344-7817
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0991893-NP CO Primary

Addresses

Primary practice location

410 Gold Pass HTS
Colorado Springs, CO 80906-3882

Mailing address

3205 N Academy Blvd Ste 130
Colorado Springs, CO 80917-5152
Phone (719) 344-7158

Other practice location 1

100 Grove St Ste 115
Worcester, MA 01605-2630
Phone (833) 904-2273

Other practice location 2

15416 N Florida Ave Ste 203
Tampa, FL 33613-1239
Phone (833) 904-2273

Other identifiers 1

IdentifierTypeStateIssuer
15770052MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NC, IN, IL4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20151027001955 CO Practitioner - Nurse Practitioner 7214246545 Reassigns benefits to 1 organization
I20220404000780 NC Practitioner - Nurse Practitioner 7214246545
I20260611001481 IN Practitioner - Nurse Practitioner 7214246545 Reassigns benefits to 1 organization
I20260615003307 IL Practitioner - Nurse Practitioner 7214246545 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

Practice addresses (Care Compare)

495 Flatbush Ave
Brooklyn, NY 11225-3706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0991893-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Sep 7, 2015 Accepting new patients
Peak Vista Community Health Centers CurrentSince Sep 7, 2015 Accepting new patients
Cityblock Medical Practice, P.a. CurrentSince Feb 1, 2022 Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

410 Gold Pass Hts
Colorado Springs, CO 80906
Phone (719) 576-3326

16115 La Salle St
South Holland, IL 60473
Phone (347) 463-5529

4444 The Plaza
Charlotte, NC 28215
Phone (336) 360-2407

1738 Owen Dr
#110111
Fayetteville, NC 28304

1840 Owen Dr
Ste 105
Fayetteville, NC 28304
Phone (630) 957-8536

1439 E Cone Blvd
Greensboro, NC 27405
Phone (336) 375-6104

624 Quaker Ln
Ste C200
High Point, NC 27262
Phone (336) 887-3164

3214 Charles B Root Wynd
Ste 203
Raleigh, NC 27612
Phone (919) 877-6800

3333 Brookview Hills Blvd
Ste 102
Winston Salem, NC 27103
Phone (336) 760-1448

55 Water St
#4C
Brooklyn, NY 11201
Phone (917) 718-2063

Interoperability endpoints

  • Direct secure messaging: nancy.prantl.1@27775.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1205203098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175152",
            "telephone_number": "719-344-7158",
            "fax_number": "719-344-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 GOLD PASS HTS",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063882",
            "telephone_number": "719-632-5700",
            "fax_number": "719-344-7817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Grove St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052630",
            "country_code": "US",
            "telephone_number": "833-904-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15416 N Florida Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336131239",
            "country_code": "US",
            "telephone_number": "833-904-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRANTL",
        "first_name": "NANCY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0991893-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15770052",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.