Individual provider Active NPI

Elizabeth Riley Allen, FNPC

  • Adult Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1245338284
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A03211 ANP Issued in AR
Practice address
2350 International CR
Colorado Springs, CO 80910
Phone
(719) 475-5065
Fax
(719) 475-5797
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A03211 ANP AR Primary
Adult Health Nurse Practitioner 363LA2200X 3092 RX AR

Addresses

Primary practice location

2350 International CR
Colorado Springs, CO 80910

Mailing address

2350 International CR
Colorado Springs, CO 80910
Phone (719) 475-5065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041215000127 CO Practitioner - Nurse Practitioner 7416914056 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3092 RXARMDAdult Health Nurse Practitioner
A03211 ANPARMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agewell Medical Associates, PC CurrentSince Apr 1, 2012 Accepting new patients

Locations

2350 International Cir
Colorado Springs, CO 80910
Phone (719) 475-5065

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1245338284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 INTERNATIONAL CR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80910",
            "telephone_number": "719-475-5065",
            "fax_number": "719-475-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 INTERNATIONAL CR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80910",
            "telephone_number": "719-475-5065",
            "fax_number": "719-475-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ELIZABETH",
        "middle_name": "RILEY",
        "name_prefix": "Mrs.",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A03211 ANP",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "3092   RX",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.