Individual provider Active NPI

Melissa Stibbens, FNP-C

  • Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1295340461
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0995917-NP Issued in CO
Practice address
1400 E Boulder St Ste 500
Colorado Springs, CO 80909-5533
Phone
(719) 364-6487
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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 0163322 CO
Nurse Practitioner 363L00000X APN.0995917-NP CO Primary

Addresses

Primary practice location

1400 E Boulder St Ste 500
Colorado Springs, CO 80909-5533

Mailing address

PO Box 267
Florissant, CO 80816-0267
Phone (303) 241-0263

Other practice location 1

2304 County Road 102
Guffey, CO 80820
Phone (303) 241-0263

Other practice location 2

1263 Lake Plaza Dr Ste 120
Colorado Springs, CO 80906-3510
Phone (719) 776-3330

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
I20201104001178 CO Practitioner - Nurse Practitioner 3375953268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder St
Suite 500 Ear Nose and Throat Clinic Mem Hosp
Colorado Springs, CO 80909-5533
Phone (719) 364-4120

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0995917-NPCOMDNurse Practitioner
0163322COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Mar 28, 2022 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Mar 28, 2022 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

4110 Briargate Pkwy
Ste 460
Colorado Springs, CO 80920
Phone (719) 364-6487

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1400 E Boulder St
Ste 500
Colorado Springs, CO 80909
Phone (719) 364-6487

1400 E Boulder St
Ste 500EAR
Colorado Springs, CO 80909
Phone (719) 364-4120

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 2

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1295340461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 267",
            "city": "FLORISSANT",
            "state": "CO",
            "postal_code": "808160267",
            "telephone_number": "303-241-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST STE 500",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-364-6487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2304 County Road 102",
            "address_purpose": "LOCATION",
            "city": "Guffey",
            "state": "CO",
            "postal_code": "80820",
            "country_code": "US",
            "telephone_number": "303-241-0263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1263 Lake Plaza Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809063510",
            "country_code": "US",
            "telephone_number": "719-776-3330",
            "fax_number": "719-776-3349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIBBENS",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0163322",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0995917-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.