NPIMap

Organization Active NPI

Parkside CT Group, LLC

  • Computed Tomography Radiologic Technologist
  • Colorado Springs, CO
National Provider Identifier
1639215833
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Computed Tomography Radiologic TechnologistTaxonomy code 2471C3401X
License
96504 Issued in CO
Legal business name
PARKSIDE CT GROUP, LLC
Practice address
215 Parkside Dr Ste 100
Colorado Springs, CO 80910-3136
Phone
(719) 471-1775
Fax
(719) 632-6055
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nancy J Tollefson
Title
Executive Director
Phone
(719) 471-1775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Computed Tomography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471C3401X 96504 CO Primary

Addresses

Primary practice location

215 Parkside Dr Ste 100
Colorado Springs, CO 80910-3136

Mailing address

215 Parkside Dr Ste 100
Colorado Springs, CO 80910-3136
Phone (719) 471-1775

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639215833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 PARKSIDE DR STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103136",
            "telephone_number": "719-471-1775",
            "fax_number": "719-632-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PARKSIDE DR STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103136",
            "telephone_number": "719-471-1775",
            "fax_number": "719-632-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE CT GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TOLLEFSON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-471-1775"
    },
    "taxonomies": [
        {
            "code": "2471C3401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": "CO",
            "license": "96504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.