John R Dygert, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0058786 Issued in CO

Practice address

218 E Cheyenne Mountain Blvd
Colorado Springs, CO 80906-3720

Phone

(719) 465-1579

Fax

(719) 280-6111

NPI assigned

Jun 17, 2009

Last updated

Sep 1, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 1, 2017 through Aug 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Pinnacle Advanced Primary Care

  • Primary Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1619644192
  NPD
• Emergency Physicians of Indiana PC

  • Emergency Medicine Physician
  • Auburn, IN
  • NPI 1003869454
  NPD (past)

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1598992521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E CHEYENNE MOUNTAIN BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063720",
            "telephone_number": "719-465-1579",
            "fax_number": "719-280-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E CHEYENNE MOUNTAIN BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063720",
            "telephone_number": "719-465-1579",
            "fax_number": "719-280-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6945 Tutt Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809233566",
            "country_code": "US",
            "telephone_number": "719-380-7235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 E College Dr",
            "address_purpose": "LOCATION",
            "city": "Colby",
            "state": "KS",
            "postal_code": "677013716",
            "country_code": "US",
            "telephone_number": "785-462-6184 x713",
            "fax_number": "785-460-1490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYGERT",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0535852",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0058786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO STATE LICENSE",
            "identifier": "0058786",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200879270A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS STATE LICENSE",
            "identifier": "05-35852",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Curtis Dwors, PH.D.
• Traci Lynn Dworshakwinterbottom
• Tucker Dye
• Jordan Alexandra Dyer, CRNA
• William Christopher Dyer, DDS
• Macy Rose Dyke
• Susan Louise Dykema
• Trisha Dawn Dykema, LMT
• Keenan Dykes
• Lara CT Dykhuis, CCC-SLP

• Family Medicine Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.