Colorado Springs Nephrology

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

COLORADO SPRINGS NEPHROLOGY

Practice address

1725 E Boulder St
Suite 105
Colorado Springs, CO 80909-5768

Phone

(866) 691-6243

NPI assigned

Oct 27, 2009

Last updated

Aug 26, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Provenzano, MD

Title

President

Phone

(719) 237-6302

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clarence Edward Adams Jr., NP

  • Adult Health Nurse Practitioner
  • Golden, CO
  • NPI 1609278290
  Medicare reassignment Care Compare group NPD
• Samia Sied Ahmed Salih, M.D.

  • Nephrology Physician
  • Colorado Springs, CO
  • NPI 1508043258
  Medicare reassignment Care Compare group
• Ameer Abdulrazzak, MD

  • Nephrology Physician
  • Roseville, MI
  • NPI 1104948280
  NPD (past)
• Hassan Abou-Rass, M.D.

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1831596428

  Nephrology

  NPD (past)
• Mohammad Alsawah

  • Internal Medicine Physician
  • Royal Oak, MI
  • NPI 1093920381
  NPD (past)
• Richard A. Berg, M.D.

  • Vascular Surgery Physician
  • Detroit, MI
  • NPI 1801883558
  NPD (past)
• Navkiranjot Brar, MD

  • Nephrology Physician
  • Shelby Township, MI
  • NPI 1235351263
  NPD (past)
• David Bryan Butcher, MD

  • Internal Medicine Physician
  • West Branch, MI
  • NPI 1164469862

  Nephrology

  NPD (past)
• Mina El Kateb, M.D.

  • Nephrology Physician
  • Detroit, MI
  • NPI 1174802292
  NPD (past)
• Mohamed El-Ghoroury, MD

  • Nephrology Physician
  • Roseville, MI
  • NPI 1700888328
  NPD (past)
• Josefine Lampasona Evola, MS, RD

  • Registered Dietitian
  • Austin, TX
  • NPI 1447488572
  NPD (past)
• Gudalia Fajardo

  • Family Nurse Practitioner
  • Port Huron, MI
  • NPI 1083019012
  NPD (past)

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1376879254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45640 SCHOENHERR RD",
            "address_2": "SUITE B",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483156033",
            "telephone_number": "866-691-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E BOULDER ST",
            "address_2": "SUITE 105",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095768",
            "telephone_number": "866-691-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPRINGS NEPHROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "PROVENZANO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-237-6302",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colorado Springs Interventional Pain Management PC
• Colorado Springs Massage LLC
• Colorado Springs Medical Investors, LLC (Life Care Center of Colorado Springs)
• Colorado Springs Medical Management, Inc. (Physicians Home Health Care)
• Colorado Springs Mental Health LLC
• Colorado Springs Neurological Associates
• Colorado Springs Neurological Associates, PC
• Colorado Springs Neurological Associates, PC
• Colorado Springs Obstetrics & Gynecology, P.C.
• Colorado Springs Ocd & Trauma Treatment Center

• Nephrology Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Nephrology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.