Organization Active NPI

Colorado Injury & Wellness

  • Chiropractor
  • Colorado Springs, CO
National Provider Identifier
1336993013
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
COLORADO INJURY & WELLNESS
Practice address
1819 W Colorado Ave
Colorado Springs, CO 80904-3836
Phone
(719) 471-4174
Fax
(719) 633-2198
NPI assigned
Apr 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Dr. Austin Frederick Clarke, DCNPI 1689243552
Title
Doctor
Phone
(719) 471-4174

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1819 W Colorado Ave
Colorado Springs, CO 80904-3836

Mailing address

1819 W Colorado Ave
Colorado Springs, CO 80904-3836
Phone (719) 471-4174

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240605001743 CO Part B Supplier - Clinic/Group Practice 3476095431 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

1819 W Colorado Ave
Colorado Springs, CO 80904
Phone (719) 471-4174

Practitioners & affiliated clinicians

Practitioners 1

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": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1336993013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 W COLORADO AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809043836",
            "telephone_number": "719-471-4174",
            "fax_number": "719-633-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 W COLORADO AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809043836",
            "telephone_number": "719-471-4174",
            "fax_number": "719-633-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO INJURY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "719-471-4174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.