Individual provider Active NPI

Emily Allen Owen

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1457236499
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0009201 Issued in CO
Practice address
400 E Pikes Peak Ave Apt 419
Colorado Springs, CO 80903-4276
Phone
(713) 819-4451
NPI assigned
Aug 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0009201 CO Primary

Addresses

Primary practice location

400 E Pikes Peak Ave Apt 419
Colorado Springs, CO 80903-4276

Mailing address

400 E Pikes Peak Ave Apt 419
Colorado Springs, CO 80903-4276
Phone (713) 819-4451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021001721 CO Practitioner - Physician Assistant 0446747208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pueblo Sports and Family Medicine, PLLCGroup PAC ID 5991060253, 2 clinicians

Practice addresses (Care Compare)

1315 Fortino Blvd
Suite C
Pueblo, CO 81008-1981
Phone (719) 544-2740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0009201COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Sports and Family Medicine PLLC CurrentSince Sep 22, 2025 Accepting new patients

Locations

1315 Fortino Blvd
Ste C
Pueblo, CO 81008
Phone (719) 544-2740

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1457236499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E PIKES PEAK AVE APT 419",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809034276",
            "telephone_number": "713-819-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E PIKES PEAK AVE APT 419",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809034276",
            "telephone_number": "713-819-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "EMILY",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0009201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.