Active NPI
NDW Management Co LLC
Doing business as Awaken IV
- Infusion Therapy Clinic/Center
- Boulder, CO
National Provider Identifier
1417810631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infusion Therapy Clinic/Center
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryLocations
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.