Organization Active NPI

Colorado Center for Neuroscience, PC

  • Neurology Physician
  • Colorado Springs, CO
National Provider Identifier
1295916989
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
COLORADO CENTER FOR NEUROSCIENCE, PC
Practice address
1715 N Weber St # 100
Colorado Springs, CO 80907-7524
Phone
(719) 955-6481
Fax
(719) 227-9013
NPI assigned
Nov 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Anne Kelly
Title
Billing
Phone
(719) 955-6481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

1715 N Weber St # 100
Colorado Springs, CO 80907-7524

Mailing address

1715 N Weber St # 100
Colorado Springs, CO 80907-7524
Phone (719) 955-6481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040720001371 CO Part B Supplier - Clinic/Group Practice 8123008380 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

7680 Goddard St
Ste 212
Colorado Springs, CO 80920
Phone (719) 800-1098

1715 N Weber St
Ste 100
Colorado Springs, CO 80907
Phone (719) 633-5660

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1295916989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 N WEBER ST # 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077524",
            "telephone_number": "719-955-6481",
            "fax_number": "719-227-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 N WEBER ST # 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077524",
            "telephone_number": "719-955-6481",
            "fax_number": "719-227-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO CENTER FOR NEUROSCIENCE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "719-955-6481"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.