Individual provider Active NPI

Susan Paige Atwood, NP

  • Gerontology Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1346285806
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
173962 Issued in CO
Practice address
825 E Pikes Peak Ave
Colorado Springs, CO 80903-3631
Phone
(719) 633-3400
Fax
(719) 633-3800
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 173962 CO Primary

Addresses

Primary practice location

825 E Pikes Peak Ave
Colorado Springs, CO 80903-3631

Mailing address

4289 Apache Plume Dr
Colorado Springs, CO 80920-7637
Phone (719) 282-8161

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
I20080305000311 CO Practitioner - Nurse Practitioner 8022193721

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173962COMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interim Healthcare of Southeastern Colorado, Inc CurrentSince Jul 24, 2022 Accepting new patients

Locations

1901 N Union Blvd
Ste 105
Colorado Springs, CO 80909
Phone (719) 314-4868

Interoperability endpoints

  • Direct secure messaging: susan.atwood@1016694758113284.direct.elationemr.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1346285806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4289 APACHE PLUME DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207637",
            "telephone_number": "719-282-8161",
            "fax_number": "719-633-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E PIKES PEAK AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033631",
            "telephone_number": "719-633-3400",
            "fax_number": "719-633-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWOOD",
        "first_name": "SUSAN",
        "middle_name": "PAIGE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "173962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.