Individual provider Active NPI

Kayla Previdi

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1619416765
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0992910 Issued in CO
Practice address
5615 Constitution Ave
Colorado Springs, CO 80915-1218
Phone
(719) 465-2819
Fax
(856) 249-9086
NPI assigned
Feb 21, 2017
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0992910 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0992910 CO Primary

Addresses

Primary practice location

5615 Constitution Ave
Colorado Springs, CO 80915-1218

Mailing address

5615 Constitution Ave
Colorado Springs, CO 80915-1218
Phone (719) 465-2819

Other practice location 1

5445 Mark Dabling Blvd
Colorado Springs, CO 80918-3800
Phone (720) 806-9662

Other names 1

  • Kayla Wakefield Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170705001013 CO Practitioner - Nurse Practitioner 3678842739 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Psychiatry, LLCGroup PAC ID 9032583745, 2 clinicians

Practice addresses (Care Compare)

5445 Mark Dabling Blvd
Suite 105
Colorado Springs, CO 80918-3850
Phone (719) 678-1425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0992910COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Medicine Specialists PC CurrentSince Jun 16, 2017 Accepting new patients
Milestone Psychiatry Inc. Psychiatric/Mental Health CurrentSince Jun 20, 2022 Accepting new patients
Summit Psychiatry, LLC Psychiatric/Mental Health CurrentSince Jul 1, 2023 Accepting new patients
Divergent Minds Mental Health PLLC Psychiatric/Mental Health CurrentSince Apr 24, 2025 Accepting new patients
Milestone Psychiatry Inc Psychiatric/Mental Health CurrentSince Jun 20, 2022 Accepting new patients

Locations

4833 Front St
Ste B
Castle Rock, CO 80104
Phone (720) 507-7017

5445 Mark Dabling Blvd
Ste 105
Colorado Springs, CO 80918
Phone (719) 301-0133

5615 Constitution Ave
Colorado Springs, CO 80915
Phone (719) 465-2819

1225 N Grand Ave
Ste 100
Pueblo, CO 81003
Phone (719) 544-5600

Interoperability endpoints

  • Direct secure messaging: kayla.previdi@cfms.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1619416765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 CONSTITUTION AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809151218",
            "telephone_number": "719-465-2819",
            "fax_number": "856-249-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 CONSTITUTION AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809151218",
            "telephone_number": "719-465-2819",
            "fax_number": "856-249-9086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5445 Mark Dabling Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809183800",
            "country_code": "US",
            "telephone_number": "720-806-9662",
            "fax_number": "856-249-9086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREVIDI",
        "first_name": "KAYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0992910",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0992910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "WAKEFIELD",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.