Individual provider Active NPI

Summer Brooke Coburn-Scheid, PA

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1336321041
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2545 Issued in CO
Practice address
4125 Briargate Pkwy
Colorado Springs, CO 80920-7804
Phone
(720) 777-6888
NPI assigned
Dec 4, 2007
Last updated
Jul 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2545 CO Primary
Medical Physician Assistant 363AM0700X PA.0002545 CO

Addresses

Primary practice location

4125 Briargate Pkwy
Colorado Springs, CO 80920-7804

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

Other practice location 1

8890 N Union Blvd
Suite 220
Colorado Springs, CO 80920-7799
Phone (719) 574-9191

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
I20080818000724 CO Practitioner - Physician Assistant 0941375422 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2545COMDClinical Psychologist
PA.0002545COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated CurrentSince Mar 5, 2016 Accepting new patients
Children's Hospital Colorado Current Accepting new patients
University Physicians, Incorporated CurrentSince Mar 5, 2016 Accepting new patients
Mountain View Medical Group, PC Hospitalist Past Accepting new patients
Children's Hospital Colorado Past Accepting new patients
Front Range Emergency Specialists, PC Past Accepting new patients
University Physicians Incorporated Physician Assistant Past Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

4090 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 305-1234

4125 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 305-8000

Interoperability endpoints

  • Direct secure messaging: scoburnscheid11494@direct.childrenscolorado.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1336321041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 BRIARGATE PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207804",
            "telephone_number": "720-777-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8890 N Union Blvd",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809207799",
            "country_code": "US",
            "telephone_number": "719-574-9191",
            "fax_number": "719-574-2829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBURN-SCHEID",
        "first_name": "SUMMER",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2545",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0002545",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.