Active NPI
Christopher Merle Nystuen, M.D.
- General Practice Physician
- Ft Carson, CO
National Provider Identifier
1528107372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- C54117
- Practice address
- 1650 Cochrane Cir
Department of Medical Readiness
Ft Carson, CO 80913-4613 - Phone
- (719) 524-7351
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | C54117 | CA | Primary |
Addresses
Primary practice location
1650 Cochrane Cir
Department of Medical Readiness
Ft Carson, CO 80913-4613
Mailing address
1650 Cochrane Cir
Ft Carson, CO 80913-4613
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C54117 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409788800000",
"number": "1528107372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 COCHRANE CIR",
"city": "FT CARSON",
"state": "CO",
"postal_code": "809134613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 COCHRANE CIR",
"address_2": "DEPARTMENT OF MEDICAL READINESS",
"city": "FT CARSON",
"state": "CO",
"postal_code": "809134613",
"telephone_number": "719-524-7351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYSTUEN",
"first_name": "CHRISTOPHER",
"middle_name": "MERLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2014-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "C54117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Carson, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.