Individual provider Active NPI

Kimberly Leib, PH.D.

  • Clinical Neuropsychologist
  • Colorado Springs, CO
National Provider Identifier
1568100204
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
5750 Issued in CO
Practice address
2312 N Nevada Ave Ste 100
Colorado Springs, CO 80907-5307
Phone
(719) 473-3272
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 5750 CO Primary

Addresses

Primary practice location

2312 N Nevada Ave Ste 100
Colorado Springs, CO 80907-5307

Mailing address

2312 N Nevada Ave Ste 100
Colorado Springs, CO 80907-5307
Phone (719) 473-3272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.53 of 100Reported as group
Quality
76.16
Promoting interoperability
100
Improvement activities
40
Cost
72.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5750COMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Springs Neurological Associates, PC CurrentSince Sep 1, 2022 Accepting new patients
Colorado Springs Neurological Associates, PC Clinical Neuropsychologist CurrentSince Sep 1, 2022 Accepting new patients
Dr. Monica Lake, PLLC Current Accepting new patients

Locations

2312 N Nevada Ave
Ste 100
Colorado Springs, CO 80907
Phone (719) 389-1108

Organizations & group practices 3

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1568100204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 N NEVADA AVE STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075307",
            "telephone_number": "719-473-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 N NEVADA AVE STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075307",
            "telephone_number": "719-473-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIB",
        "first_name": "KIMBERLY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "5750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.