Individual provider Active NPI

Michelle Egbert, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1205420056
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0996218-NP Issued in CO
Practice address
5278 Fraser Valley LN
Colorado Springs, CO 80924-8205
Phone
(719) 826-6605
Fax
(719) 888-1718
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0996218-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0996218-NP CO Primary

Addresses

Primary practice location

5278 Fraser Valley LN
Colorado Springs, CO 80924-8205

Mailing address

3720 Sinton Rd Ste 104
Colorado Springs, CO 80907-5085
Phone (719) 493-9555

Other practice location 1

3720 Sinton Rd Ste 104
Colorado Springs, CO 80907-5085
Phone (719) 493-9555

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122001591 CO Practitioner - Nurse Practitioner 8325416365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bundukamara IncGroup PAC ID 2567714843, 8 clinicians

Practice addresses (Care Compare)

3720 Sinton Rd
Suite 104
Colorado Springs, CO 80907-5085
Phone (719) 493-9555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0996218-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bundukamara Inc Psychiatric/Mental Health CurrentSince Aug 1, 2022 Accepting new patients

Locations

3720 Sinton Rd
Ste 104
Colorado Springs, CO 80907
Phone (719) 493-9555

Organizations & group practices 1

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": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1205420056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 SINTON RD STE 104",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075085",
            "telephone_number": "719-493-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5278 FRASER VALLEY LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809248205",
            "telephone_number": "719-826-6605",
            "fax_number": "719-888-1718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3720 Sinton Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809075085",
            "country_code": "US",
            "telephone_number": "719-493-9555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGBERT",
        "first_name": "MICHELLE",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0996218-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0996218-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.