Individual provider Active NPI

Kyle Tipton, CRNA

  • Certified Registered Nurse Anesthetist
  • Pueblo, CO
National Provider Identifier
1336507847
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
111291 Issued in CO
Practice address
4741 Eagleridge Circle
206
Pueblo, CO 81008
Phone
(870) 917-5734
NPI assigned
Jan 29, 2016
Last updated
Mar 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 111291 CO Primary

Addresses

Primary practice location

4741 Eagleridge Circle
206
Pueblo, CO 81008

Mailing address

4741 Eagleridge Cir Apt 206
Pueblo, CO 81008-2272
Phone (870) 917-5734

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160924000122 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406143049 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monarch Anesthesia LLCGroup PAC ID 0941293708, 7 clinicians

Practice addresses (Care Compare)

1000 Rush Dr
Salida, CO 81201-9627
Phone (719) 530-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
111291COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Anesthesia of the Rocky Mountains, LLC CurrentSince Jun 1, 2022 Accepting new patients
Pueblo Pathology Group, PC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Monarch Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 7, 2024 Accepting new patients

Locations

1699 Medical Center Pt
Colorado Springs, CO 80907
Phone (719) 387-2144

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

1000 Rush Dr
Salida, CO 81201
Phone (719) 530-2265

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1336507847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 EAGLERIDGE CIR APT 206",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082272",
            "telephone_number": "870-917-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 EAGLERIDGE CIRCLE",
            "address_2": "206",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81008",
            "telephone_number": "870-917-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "KYLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-29",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "111291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.