Individual provider Active NPI

Laura Williams, DO

  • Psychiatry Physician
  • Colorado Springs, CO
National Provider Identifier
1417419292
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2023-01824 Issued in NC
Practice address
1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone
(719) 572-6100
NPI assigned
Apr 2, 2019
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DR.0074612 CO
Psychiatry Physician 2084P0800X 2023-01824 NC Primary

Addresses

Primary practice location

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332

Mailing address

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-5095

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-5095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240117000374 NC Practitioner - Psychiatry 2264761501 Reassigns benefits to 1 organization
I20250430002672 CO Practitioner - Psychiatry 2264761501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Diversus Health IncGroup PAC ID 7719879204, 49 clinicians

Practice addresses (Care Compare)

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone (719) 572-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DR.0074612COMDPsychiatry Physician
2023-01824NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diversus Health Inc Current Accepting new patients
Diversus Health Inc CurrentSince Apr 23, 2025 Accepting new patients
Cumberland County Hospital System Inc Psychiatry CurrentSince Oct 30, 2023 Accepting new patients
Diversus Health Inc CurrentSince Apr 23, 2025 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cumberland County Hospital System Inc CurrentSince Oct 30, 2023 Accepting new patients

Locations

460 County Road 43
Ste 7
Bailey, CO 80421
Phone (303) 838-5013

328 10th St
Calhan, CO 80808

115 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6340

179 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6300

1795 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 572-6111

220 Ruskin Dr
Colorado Springs, CO 80910
Phone (719) 572-6150

413 Security Blvd
Colorado Springs, CO 80911

6208 Lehman Dr
Colorado Springs, CO 80918
Phone (303) 730-0205

875 W Moreno Ave
Colorado Springs, CO 80905
Phone (719) 572-6200

18401 Highway 24
Ste 119
Woodland Park, CO 80863

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

Interoperability endpoints

  • Direct secure messaging: lwilliams69706@capefearvalley.direct-ci.com

Organizations & group practices 6

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1417419292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-5095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LAURA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0074612",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2023-01824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.