Individual provider Active NPI

Stephanie CC Yu Chon, RN CPNP

  • Pediatric Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1275835530
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RXN0101155NP Issued in CO
Practice address
4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075
Phone
(719) 632-4455
Fax
(719) 418-2123
NPI assigned
Nov 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 991605 CO
Pediatric Nurse Practitioner 363LP0200X 590290 TX
Pediatric Nurse Practitioner 363LP0200X RXN0101155NP CO Primary

Addresses

Primary practice location

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075

Mailing address

4190 E Woodmen Rd Ste 100
Colorado Springs, CO 80920-8075
Phone (719) 632-4455

Other identifiers 3

IdentifierTypeStateIssuer
APN.0091605-NPOtherCOCOLORADO ADVANCE PRACTICE LICENSE
590290OtherTXTX RN LICENSE
94435821MedicaidCO

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
I20190502002786 CO Practitioner - Nurse Practitioner 6507125770 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
991605COMDPediatrics Physician
RXN0101155NPCOMDPediatric Nurse Practitioner
590290TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews-Vu Medical Group, P.C. CurrentSince Jan 12, 2019 Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Jan 12, 2019 Accepting new patients
Alpine Medical Group Colorado PLLC Pediatrics CurrentSince Oct 21, 2025 Accepting new patients

Locations

4150 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (719) 418-2121

4190 E Woodmen Rd
Colorado Springs, CO 80920
Phone (719) 722-2542

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 364-4851

104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707

999 17th St
Ste 500
Denver, CO 80202
Phone (720) 355-0539

Interoperability endpoints

  • Direct secure messaging: stephanie.chon@mvmg.eclinicaldirectplus.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": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1275835530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075",
            "telephone_number": "719-632-4455",
            "fax_number": "719-633-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 E WOODMEN RD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208075",
            "telephone_number": "719-632-4455",
            "fax_number": "719-418-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHON",
        "first_name": "STEPHANIE",
        "middle_name": "CC YU",
        "credential": "RN CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "991605",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "590290",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "RXN0101155NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO ADVANCE PRACTICE LICENSE",
            "identifier": "APN.0091605-NP",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX RN LICENSE",
            "identifier": "590290",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94435821",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.