Individual provider Active NPI

Carissa Shea

  • Acute Care Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1356980304
Registry record updated Dec 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RXN.0104425-NP Issued in CO
Practice address
2222 N Nevada Ave
Colorado Springs, CO 80907-6819
Phone
(719) 776-5000
NPI assigned
Dec 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RXN.0104425-NP CO
Acute Care Nurse Practitioner 363LA2100X RXN.0104425-NP CO Primary

Addresses

Primary practice location

2222 N Nevada Ave
Colorado Springs, CO 80907-6819

Mailing address

2222 N Nevada Ave Ste 1
Colorado Springs, CO 80907-6794

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
I20200220001439 CO Practitioner - Nurse Practitioner 9436586047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

2222 N Nevada Ave
Colorado Springs, CO 80907-6819

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

  • Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RXN.0104425-NPCOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Mar 22, 2020 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Mar 22, 2020 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

2222 N Nevada Ave
Ste 1
Colorado Springs, CO 80907
Phone (303) 290-6500

2222 N Nevada Ave
Ste 5001
Colorado Springs, CO 80907
Phone (719) 776-3580

2222 N Nevada Ave
Ste 4007
Colorado Springs, CO 80907
Phone (719) 634-6671

2222 N Nevada Ave
Colorado Springs, CO 80907
Phone (719) 776-5333

6001 E Woodmen Rd
Colorado Springs, CO 80923
Phone (719) 571-1000

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1576886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576886400000",
    "number": "1356980304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE STE 1",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076819",
            "telephone_number": "719-776-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "CARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-21",
        "last_updated": "2019-12-21",
        "certification_date": "2019-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "RXN.0104425-NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "RXN.0104425-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.