Individual provider Active NPI

Shannon Graves

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1376169763
Registry record updated Sep 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0995563 Issued in CO
Practice address
9362 Grand Cordera Pkwy Ste 100
Colorado Springs, CO 80924-7007
Phone
(719) 345-0429
NPI assigned
Jun 22, 2020
Last updated
Sep 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0995563 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0995563 CO Primary

Addresses

Primary practice location

9362 Grand Cordera Pkwy Ste 100
Colorado Springs, CO 80924-7007

Mailing address

9362 Grand Cordera Pkwy Ste 100
Colorado Springs, CO 80924-7007
Phone (719) 345-0429

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
I20200811001870 CO Practitioner - Nurse Practitioner 5092131888 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

9362 Grand Cordera Pkwy
Suite 100
Colorado Springs, CO 80924-7007
Phone (888) 374-5066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0995563COMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Sep 22, 2021 Accepting new patients
Apex Physical Medicine and Rehabilitation Professional LLC CurrentSince Sep 1, 2024 Accepting new patients
Family Care Center, LLC Psychiatric/Mental Health CurrentSince Jun 18, 2025 Accepting new patients
Family Care Center, LLC CurrentSince Jun 18, 2025 Accepting new patients
Apex Physical Medicine and Rehabilitation Professional LLC CurrentSince Sep 1, 2024 Accepting new patients
Apex Physical Medicine and Rehabilitation Professional LLC Current Accepting new patients
Apex Physical Medicine and Rehabilitation Professional LLC Current Accepting new patients
Peak Vista Community Health Centers CurrentSince Sep 22, 2021 Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

9362 Grand Cordera Pkwy
Ste 100
Colorado Springs, CO 80924
Phone (719) 345-0429

1605 N Union Blvd
Colorado Springs, CO 80909
Phone (719) 447-0818

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

3910 S Carefree Cir
Ste F
Colorado Springs, CO 80917
Phone (719) 463-7725

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756684800000",
    "number": "1376169763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9362 GRAND CORDERA PKWY STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809247007",
            "telephone_number": "719-345-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9362 GRAND CORDERA PKWY STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809247007",
            "telephone_number": "719-345-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2025-09-01",
        "certification_date": "2025-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0995563",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0995563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.