NPIMap

Organization Active NPI

Davita Medical Group Colorado Springs, LLC

Doing business as DaVita Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Colorado Springs, CO
National Provider Identifier
1205359155
Registry record updated Jul 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DAVITA MEDICAL GROUP COLORADO SPRINGS, LLC
Doing business as
DaVita Medical Group
Practice address
1633 Medical Center PT
Colorado Springs, CO 80907-5700
Phone
(719) 636-2999
NPI assigned
Jul 24, 2017
Last updated
Jul 24, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
DAVITA MEDICAL GROUP COLORADO SPRINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2017

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

Authorized official

Name
Vijay Kotte
Title
Treasurer
Phone
(303) 876-6457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1633 Medical Center PT
Colorado Springs, CO 80907-5700

Mailing address

2 S Cascade Ave Ste 140
Colorado Springs, CO 80903-1604
Phone (719) 866-6571

Other names 1

  • DaVita Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Optumcare Co Springs LLC61 organizations share this tax ID, including this one
Part of
Optumcare Co Springs LLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500854400000",
    "number": "1205359155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S CASCADE AVE STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031604",
            "telephone_number": "719-866-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 MEDICAL CENTER PT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075700",
            "telephone_number": "719-636-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA MEDICAL GROUP COLORADO SPRINGS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA MEDICAL GROUP COLORADO SPRINGS, LLC",
        "enumeration_date": "2017-07-24",
        "last_updated": "2017-07-24",
        "status": "A",
        "authorized_official_last_name": "KOTTE",
        "authorized_official_first_name": "VIJAY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "303-876-6457"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVita Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DaVita Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.