NPIMap

Individual provider Active NPI

Kimberly Ann Robertson, AGACNP-BC

  • Gerontology Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1407333446
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71012049A Issued in IN
Practice address
5770 Flintridge Dr Ste 100
Colorado Springs, CO 80918-1870
Phone
(719) 445-9902
Fax
(719) 387-0312
NPI assigned
Jul 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 71012049A IN Primary

Addresses

Primary practice location

5770 Flintridge Dr Ste 100
Colorado Springs, CO 80918-1870

Mailing address

5770 Flintridge Dr Ste 100
Colorado Springs, CO 80918-1870
Phone (719) 445-9902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181001001807 CO Practitioner - Nurse Practitioner 2961753983 Reassigns benefits to 1 organization
I20220121001067 IN Practitioner - Nurse Practitioner 2961753983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Neurology Corp PCGroup PAC ID 0042592339, 7 clinicians

Practice addresses (Care Compare)

5770 Flintridge Dr
Suite 100
Colorado Springs, CO 80918-1870
Phone (719) 445-9902

Hospital & facility affiliations

  • Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031
  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

Merit-based Incentive Payment System (MIPS)

Final score
64.63 of 100Reported as group
Quality
44.01
Improvement activities
40
Cost
56.75

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001458COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Neurology Corp PC CurrentSince Dec 2, 2024 Accepting new patients
Peak Neurology Corp PC CurrentSince Dec 7, 2025 Accepting new patients
Access Telecare, PLLC CurrentSince Dec 28, 2023 Accepting new patients
Seymour Indiana Pathologists, Inc Past Accepting new patients
Agape Palliative Services, LLC PastSince Aug 1, 2018 Accepting new patients

Locations

5770 Flintridge Dr
Ste 100
Colorado Springs, CO 80918
Phone (719) 445-9902

6285 Lehman Dr
Ste 100
Colorado Springs, CO 80918
Phone (719) 445-9902

3464 S Willow St
Ste 10
Denver, CO 80231

Organizations & group practices 5

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 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1407333446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 FLINTRIDGE DR STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181870",
            "telephone_number": "719-445-9902",
            "fax_number": "719-387-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 FLINTRIDGE DR STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181870",
            "telephone_number": "719-445-9902",
            "fax_number": "719-387-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71012049A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.