Active NPI
Stephanie CC Yu Chon, RN CPNP
- Pediatric Nurse Practitioner
- Colorado Springs, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RXN0101155NP
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APN.0091605-NP | Other | CO | COLORADO ADVANCE PRACTICE LICENSE |
| 590290 | Other | TX | TX RN LICENSE |
| 94435821 | Medicaid | CO |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 991605 | CO | MD | Pediatrics Physician |
| RXN0101155NP | CO | MD | Pediatric Nurse Practitioner |
| 590290 | TX | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matthews-Vu Medical Group, P.C. | Current | Accepting new patients | |
| Matthews-Vu Medical Group, P.C. | Current | Accepting new patients | |
| Alpine Medical Group Colorado PLLC | Pediatrics | Current | 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
- 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.
-
- Internal Medicine Physician
- Colorado Springs, CO
- NPI 1649438433
-
- Multi-Specialty Clinic/Center
- Colorado Springs, CO
- NPI 1528735107
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.