NPIMap

Organization Active NPI

Memorial Health System

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Colorado Springs, CO
National Provider Identifier
1316265705
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
MEMORIAL HEALTH SYSTEM
Practice address
175 S Union Blvd
#115
Colorado Springs, CO 80910-3113
Phone
(719) 365-9951
NPI assigned
May 10, 2010
Organization subpart
Yes
Parent organization
MEMORIAL HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Authorized official

Name
Mary Jo Yantis
Title
Vice President
Phone
(719) 365-9951

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

175 S Union Blvd
#115
Colorado Springs, CO 80910-3113

Mailing address

175 S Union Blvd
#115
Colorado Springs, CO 80910-3113
Phone (719) 365-9951

Other names 1

  • Memorial Physician Network-Cardiothoracic Surgery Doing business as

National Provider Directory

National Provider Directory
Part of
Memorial Health System

Locations

175 S Union Blvd
Ste 115
Colorado Springs, CO 80910
Phone (719) 365-5445

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276646400000",
    "number": "1316265705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S UNION BLVD",
            "address_2": "#115",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103113",
            "telephone_number": "719-365-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S UNION BLVD",
            "address_2": "#115",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103113",
            "telephone_number": "719-365-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HEALTH SYSTEM",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-06-16",
        "status": "A",
        "authorized_official_last_name": "YANTIS",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "719-365-9951"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Physician Network-Cardiothoracic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 16, 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.