Individual provider Active NPI

Malory Kay Splawn, FNP-C

  • Family Nurse Practitioner
  • Fountain, CO
National Provider Identifier
1235805136
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0998519-NP Issued in CO
Practice address
350 Lyckman PL
Fountain, CO 80817-2861
Phone
(719) 632-5700
NPI assigned
Aug 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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 95017787 CA
Family Nurse Practitioner 363LF0000X APN.0998519-NP CO Primary

Addresses

Primary practice location

350 Lyckman PL
Fountain, CO 80817-2861

Mailing address

7538 Waterside Dr
Colorado Springs, CO 80925-9572
Phone (760) 223-3756

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
I20231024000323 CO Practitioner - Nurse Practitioner 1052718558 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
Group practices
Peak Vista Community Health CentersGroup PAC ID 4688583974, 126 clinicians

Practice addresses (Care Compare)

1400 E Boulder
Colorado Springs, CO 80909-5533
Phone (719) 776-5000

722 S Wahsatch Ave
Colorado Springs, CO 80903-4035
Phone (719) 776-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95030205CAMDNurse Practitioner
95017787CAMDFamily Nurse Practitioner
APN.0998519-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kern Valley Healthcare District CurrentSince Aug 16, 2021 Accepting new patients
Peak Vista Community Health Centers CurrentSince Nov 1, 2023 Accepting new patients
Peak Vista Community Health Centers CurrentSince Nov 1, 2023 Accepting new patients
Kern Valley Healthcare District CurrentSince Aug 16, 2021 Accepting new patients
Plumas District Hospital Past Accepting new patients
Plumas District Hospital Past Accepting new patients
Peak Vista Community Health Centers Past Accepting new patients
Plumas District Hospital Past Accepting new patients

Locations

6412 Laurel Ave
Mountain Mesa, CA 93240
Phone (760) 379-2681

4300 Birch St
Mountain Mesa, CA 93240
Phone (760) 379-1791

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

350 Lyckman Pl
Fountain, CO 80817
Phone (719) 322-0777

Interoperability endpoints

  • Direct secure messaging: malory.splawn.p1@direct.peakvista.nextgenshare.com
  • FHIR API: https://fhir-usa.unify.chbase.com/org/kernvh-26e64ef3
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d09b5303-02b3-4cca-b4b2-ddf355d54e88/

Organizations & group practices 8

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": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1235805136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7538 WATERSIDE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809259572",
            "telephone_number": "760-223-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 LYCKMAN PL",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808172861",
            "telephone_number": "719-632-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPLAWN",
        "first_name": "MALORY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017787",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0998519-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain, CO

Sources for this page

Verify at the official NPI Registry.