NPIMap

Individual provider Active NPI

Shizuka Buckner, FNP-C

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1306324751
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0993637-NP Issued in CO
Practice address
1220 Lake Plaza Dr Ste 150
Colorado Springs, CO 80906-3548
Phone
(719) 365-3600
Fax
(719) 365-3601
NPI assigned
Jul 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0993637-NP CO Primary

Addresses

Primary practice location

1220 Lake Plaza Dr Ste 150
Colorado Springs, CO 80906-3548

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4123

Other practice location 1

445 Union Blvd Ste 223
Lakewood, CO 80228-1241
Phone (720) 353-4078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190912000054 CO Practitioner - Nurse Practitioner 5193054492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1220 Lake Plaza Dr
Colorado Springs, CO 80906-3548
Phone (719) 365-3600

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Uchealth Grandview Hospital Hospital, Colorado Springs, CO, CCN 060130

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Sep 3, 2019 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 7, 2023 Accepting new patients
Peak Vista Community Health Centers CurrentSince Sep 3, 2019 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 7, 2023 Accepting new patients

Locations

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

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

350 Printers Pkwy
Colorado Springs, CO 80910
Phone (719) 596-2020

1220 Lake Plaza Dr
Ste 150
Colorado Springs, CO 80906
Phone (719) 365-3600

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

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

Organizations & group practices 4

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1532822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1306324751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4123",
            "fax_number": "970-490-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 LAKE PLAZA DR STE 150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063548",
            "telephone_number": "719-365-3600",
            "fax_number": "719-365-3601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "445 Union Blvd Ste 223",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281241",
            "country_code": "US",
            "telephone_number": "720-353-4078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "SHIZUKA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-29",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0993637-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.