Colorado Spine Pain & Sports Medicine PC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

40977 Issued in CO

Legal business name

COLORADO SPINE PAIN & SPORTS MEDICINE PC

Practice address

1437 Riverside Ave
Fort Collins, CO 80524-4324

Phone

(970) 495-0300

NPI assigned

Feb 7, 2008

Last updated

Jun 7, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ricardo A Nieves, MDNPI 1003909276

Title

President

Phone

(970) 692-5550

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ricardo A Nieves, MD

  • Interventional Pain Medicine Physician
  • Fort Collins, CO
  • NPI 1003909276
  Authorized official Same address or phone

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275868800000",
    "number": "1306024708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244324",
            "telephone_number": "970-692-5550",
            "fax_number": "970-692-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1437 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244324",
            "telephone_number": "970-495-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPINE PAIN & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2010-06-07",
        "status": "A",
        "authorized_official_last_name": "NIEVES",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-692-5550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CO",
            "license": "40977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19823738",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colorado Physical Therapy Specialists PLLC (Colorado in Motion)
• Colorado Physical Therapy Specialists PLLC (Colorado In Motion)
• Colorado Physical Therapy Specialists PLLC (Colorado In Motion)
• Colorado Restore Muscle & Joint LLC
• Colorado Speech Therapy LLC
• Colorado State University (Kendall Reagan Nutrition Center)
• Colorado State University (Hartshorn Health Service)
• Colorado State University (Center for Family and Couple Therapy)
• Colorado State University (CSU Health Network)
• Colorado State University

• Interventional Pain Medicine Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Interventional Pain Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.