Anna Marie Mack, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0995856 Issued in CO

Practice address

225 S Union Blvd
Colorado Springs, CO 80910-3184

Phone

(719) 632-5700

NPI assigned

Sep 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Anna Marie Coleman Otte Other name

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Vista Community Health CentersGroup PAC ID 4688583974, 126 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anna.otte.p1@direct.peakvista.nextgenshare.com

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.

• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1730166034
  Medicare reassignment Care Compare group NPD
• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1871347443
  NPD
• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1124321880
  NPD (past)

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1366057424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175152",
            "telephone_number": "719-632-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S UNION BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103184",
            "telephone_number": "719-632-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0995856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "OTTE",
            "middle_name": "MARIE COLEMAN",
            "credential": "NP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rachel Macias, LCSW
• Lyndsey Maciejewski
• Hayley Maciel
• Chamisa Macindoe, D.O.
• Emily R Macindoe, MSW, LCSW
• Eric Nicholas Mack, OTR/L
• Erin Mack
• Hillary Mack, DO
• Jade Lindsey Mack, LMFT
• Leah Mack, DPT

• Family Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.