Individual provider Active NPI

Aimee D Johnson-Wirt, M.D.

  • Pediatrics Physician
  • Colorado Springs, CO
National Provider Identifier
1457551392
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR.0055826 Issued in CO
Practice address
2405 Research Parkway
Colorado Springs, CO 80920
Phone
(719) 522-1134
Fax
(719) 268-2819
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0055826 CO Primary

Addresses

Primary practice location

2405 Research Parkway
Colorado Springs, CO 80920

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (719) 463-5600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151008001090 CO Practitioner - Pediatric Medicine 4385952571 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Colorado Medical Group LLC CurrentSince Sep 16, 2015 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Sep 16, 2015 Accepting new patients

Locations

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

8890 N Union Blvd
Ste 220
Colorado Springs, CO 80920
Phone (719) 574-9191

2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900

2405 Research Pkwy
Colorado Springs, CO 80920
Phone (719) 268-2800

Interoperability endpoints

  • Direct secure messaging: ajohnsonwirt119179@westdirect.optum.com

Organizations & group practices 2

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": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1457551392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "719-463-5600",
            "fax_number": "719-538-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 RESEARCH PARKWAY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80920",
            "telephone_number": "719-522-1134",
            "fax_number": "719-268-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-WIRT",
        "first_name": "AIMEE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0055826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.