Individual provider Active NPI

Jordan Alexandra Dyer, CRNA

  • Certified Registered Nurse Anesthetist
  • Colorado Springs, CO
National Provider Identifier
1578062444
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C-APN.0000957-C-CRNA Issued in CO
Practice address
2920 N Cascade Ave Ste 300
Colorado Springs, CO 80907-6262
Phone
(719) 636-1201
Fax
(719) 636-1326
NPI assigned
Feb 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X C-APN.0000957-C-CRNA CO Primary

Addresses

Primary practice location

2920 N Cascade Ave Ste 300
Colorado Springs, CO 80907-6262

Mailing address

2920 N Cascade Ave Ste 300
Colorado Springs, CO 80907-6262
Phone (719) 636-1201

Other practice location 1

400 W 16th St
Pueblo, CO 81003-2745
Phone (719) 584-4000

Other names 1

  • Jordan Alexandra Timothy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180319000377 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810259561 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
C-APN.0000957-C-CRNACOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Pathology Group, PC Current Accepting new patients
US Anesthesia Partners of Colorado Inc. Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Peak Gastroenterology Associates CurrentSince Aug 4, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

2222 N Nevada Ave
Colorado Springs, CO 80907
Phone (719) 776-5333

1615 Medical Center Pt
Colorado Springs, CO 80907
Phone (719) 635-7740

2920 N Cascade Ave
#P
Colorado Springs, CO 80907

2920 N Cascade Ave
Ste 1
Colorado Springs, CO 80907

2920 N Cascade Ave
Ste 300
Colorado Springs, CO 80907

10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000

9101 Kimmer Dr
Ste 1000
Lone Tree, CO 80124
Phone (720) 639-8946

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

408 N Main St
Fl 2
Pueblo, CO 81003
Phone (719) 584-4000

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1578062444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 N CASCADE AVE STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076262",
            "telephone_number": "719-636-1201",
            "fax_number": "719-636-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N CASCADE AVE STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076262",
            "telephone_number": "719-636-1201",
            "fax_number": "719-636-1326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W 16th St",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810032745",
            "country_code": "US",
            "telephone_number": "719-584-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYER",
        "first_name": "JORDAN",
        "middle_name": "ALEXANDRA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "C-APN.0000957-C-CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "TIMOTHY",
            "middle_name": "ALEXANDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.