Individual provider Active NPI

Kolbie Gardner, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1356750145
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0996759-NP Issued in CO
Practice address
1600 W 24TH St
Pueblo, CO 81003-1411
Phone
(719) 546-4000
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.1621910 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0996759-NP CO Primary

Addresses

Primary practice location

1600 W 24TH St
Pueblo, CO 81003-1411

Mailing address

1600 W 24TH St
Pueblo, CO 81003-1411
Phone (719) 546-4000

Other practice location 1

1 Wellness Way
Pueblo, CO 81006-2103
Phone (719) 545-2746

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
I20231017001678 CO Order and Referring Only - Nurse Practitioner 8022463678

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.1621910COMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1356750145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 24TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031411",
            "telephone_number": "719-546-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 24TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031411",
            "telephone_number": "719-546-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wellness Way",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810062103",
            "country_code": "US",
            "telephone_number": "719-545-2746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "KOLBIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.1621910",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0996759-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.