Restore Health Family Practice

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

RESTORE HEALTH FAMILY PRACTICE

Practice address

1235 Lake Plaza Dr Ste 220
Colorado Springs, CO 80906-3556

Phone

(719) 292-5051

Fax

(719) 306-0183

NPI assigned

Mar 25, 2021

Organization subpart

No

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

Authorized official

Name

Aleathia Ware, NPNPI 1184858581

Title

Owner/Operator

Phone

(719) 292-5051

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aleathia Channel Ware, FNP

  • Family Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1184858581
  Medicare reassignment Care Compare group NPD Authorized official
• Robert Facer Jensen, NP

  • Family Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1760853600
  Medicare reassignment Care Compare group NPD
• Ava J Roberts, PODIATRIST DPM

  • Foot Surgery Podiatrist
  • Colorado Springs, CO
  • NPI 1467451583
  Medicare reassignment Care Compare group NPD
• Christine Janel Haywood Bong, M.D., FAAP, M.P.H.

  • Pediatrics Physician
  • Colorado Springs, CO
  • NPI 1992827653
  Medicare reassignment NPD
• Nicole McKinney, MD

  • Pediatrics Physician
  • Colorado Springs, CO
  • NPI 1114073889
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1295312288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 LAKE PLAZA DR STE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063556",
            "telephone_number": "719-292-5051",
            "fax_number": "719-306-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 LAKE PLAZA DR STE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063556",
            "telephone_number": "719-292-5051",
            "fax_number": "719-306-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE HEALTH FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "ALEATHIA",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "719-292-5051",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91224560",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Restored Ground Therapy and Counseling LLC
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• Restoring Lives Counseling Services
• Restoring You Therapy

• Primary Care Clinic/Center in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.