Organization Active NPI

NDW Management Co LLC

Doing business as Awaken IV

  • Infusion Therapy Clinic/Center
  • Boulder, CO
National Provider Identifier
1417810631
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
NDW MANAGEMENT CO LLC
Doing business as
Awaken IV
Practice address
5277 Manhattan Cir Ste 260
Boulder, CO 80303-8201
Phone
(303) 409-3690
NPI assigned
Dec 4, 2025
Last updated
Sep 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Authorized official

Name
Nicholas Wingo
Title
Ceo
Phone
(720) 964-2402

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

5277 Manhattan Cir Ste 260
Boulder, CO 80303-8201

Mailing address

5277 Manhattan Cir Ste 260
Boulder, CO 80303-8201
Phone (720) 964-2402

Other names 1

  • Awaken IV Doing business as

National Provider Directory

National Provider Directory

Locations

5277 Manhattan Cir
Ste 260
Boulder, CO 80303
Phone (720) 961-5460

NPI Registry JSON

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

{
    "created_epoch": "1764806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1417810631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5277 MANHATTAN CIR STE 260",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803038201",
            "telephone_number": "720-964-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5277 MANHATTAN CIR STE 260",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803038201",
            "telephone_number": "303-409-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NDW MANAGEMENT CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-04",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "WINGO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-964-2402"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Awaken IV",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.