Individual provider Active NPI

Aaron E Fedewa, NP

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1629353537
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0993296-NP Issued in CO
Practice address
2767 Janitell Rd
Colorado Springs, CO 80906-4102
Phone
(719) 365-2888
NPI assigned
Oct 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 186578 CO
Registered Nurse 163W00000X 4704253266 MI
Registered Nurse 163W00000X 736242 MI
Registered Nurse 163W00000X RN.0186578 CO
Family Nurse Practitioner 363LF0000X 4704253266 MI
Family Nurse Practitioner 363LF0000X APN.0993296-NP CO Primary

Addresses

Primary practice location

2767 Janitell Rd
Colorado Springs, CO 80906-4102

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4034

Other practice location 1

2332 Alpine Ave NW
Grand Rapids, MI 49544-1955
Phone (616) 391-6236

Other practice location 2

2332 Alpine Ave NW
Grand Rapids, MI 49544-1955
Phone (616) 391-6236

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
I20171201000400 CO Practitioner - Nurse Practitioner 4486821964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
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)

2767 Janitell Rd
Colorado Springs, CO 80906-4102
Phone (719) 365-2888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
186578COMDRegistered Nurse
RN.0186578COMDRegistered Nurse
736242MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jan 29, 2018 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 29, 2018 Accepting new patients

Locations

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

1035 Garden of the Gods Rd
Ste 120
Colorado Springs, CO 80907
Phone (719) 329-1000

4323 Integrity Center Pt
Colorado Springs, CO 80917
Phone (719) 591-2558

2767 Janitell Rd
Colorado Springs, CO 80906
Phone (719) 365-2888

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

13445 Voyager Pkwy
Colorado Springs, CO 80921
Phone (719) 219-0333

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 2

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629353537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 JANITELL RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064102",
            "telephone_number": "719-365-2888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2332 Alpine Ave NW",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495441955",
            "country_code": "US",
            "telephone_number": "616-391-6236",
            "fax_number": "616-365-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2332 Alpine Ave NW",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495441955",
            "country_code": "US",
            "telephone_number": "616-391-6236",
            "fax_number": "616-365-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDEWA",
        "first_name": "AARON",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "186578",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704253266",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "736242",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0186578",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704253266",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0993296-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.