Active NPI
Colleen J Speidell, FNP-BC
- Family Nurse Practitioner
- Prescott, AZ
National Provider Identifier
1639164072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN084306
- Practice address
- 1003 Division St Ste 2
Prescott, AZ 86301-1657 - Phone
- (928) 777-0700
- Fax
- (928) 778-5507
- NPI assigned
- Sep 13, 2005
- Last updated
- Jan 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN084306 | AZ | Primary |
Addresses
Primary practice location
1003 Division St Ste 2
Prescott, AZ 86301-1657
Mailing address
PO Box 10880
Prescott, AZ 86304-0880
Phone (928) 759-5987
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2020 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN084306 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colleen J. Speidell NP PLC | Family | Past | Accepting new patients |
| Lee D. Hieb, M.D., P.C. | Past | Accepting new patients | |
| Yuma Ear, Nose and Throat, LTD | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1639164072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10880",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863040880",
"telephone_number": "928-759-5987",
"fax_number": "928-458-2039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 DIVISION ST STE 2",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011657",
"telephone_number": "928-777-0700",
"fax_number": "928-778-5507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEIDELL",
"first_name": "COLLEEN",
"middle_name": "J",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-13",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "RN084306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.