NPIMap

Individual provider Active NPI

Audrey L Gentile, NP

  • Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1639806912
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0997843.NP Issued in CO
Practice address
2429 S Prairie Ave
Pueblo, CO 81005-2886
Phone
(719) 564-5070
Fax
(719) 896-2874
NPI assigned
Aug 5, 2022
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APN.0997843.NP CO
Nurse Practitioner 363L00000X APN.0997843.NP CO Primary

Addresses

Primary practice location

2429 S Prairie Ave
Pueblo, CO 81005-2886

Mailing address

2429 S Prairie Ave
Pueblo, CO 81005-2886
Phone (719) 564-5070

Other practice location 1

602 Yale Pl
Canon City, CO 81212-4611
Phone (719) 275-0700

Other names 1

  • Audrey L. Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221214002451 CO Practitioner - Nurse Practitioner 3173992187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rocky Mountain Cancer Centers LLPGroup PAC ID 7012820533, 131 clinicians

Practice addresses (Care Compare)

525 W 15TH St
Suite 200
Pueblo, CO 81003-2716
Phone (719) 296-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0997843.NPCOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Vein Institute Professional LLC CurrentSince Nov 7, 2022 Accepting new patients
Rocky Mountain Cancer Centers LLP Nurse Practitioner CurrentSince Sep 23, 2025 Accepting new patients
Goodness Health, LLC Gerontology CurrentSince Jan 15, 2024 Accepting new patients
Rocky Mountain Vein Institute, PLLC CurrentSince Nov 7, 2022 Accepting new patients
Rocky Mountain Cancer Centers, LLP CurrentSince Sep 23, 2025 Accepting new patients
Goodness Health, LLC Gerontology CurrentSince Jan 15, 2024 Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients

Locations

3027 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 577-2555

115 E Riverwalk
Unit 200
Pueblo, CO 81003
Phone (719) 543-8346

525 W 15th St
Ste 200
Pueblo, CO 81003
Phone (719) 296-6000

Interoperability endpoints

  • Direct secure messaging: audrey.gentile.1@31545.direct.athenahealth.com
  • Direct secure messaging: audrey.gentile@rmcc.ikm.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1639806912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 S PRAIRIE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052886",
            "telephone_number": "719-564-5070",
            "fax_number": "719-896-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2429 S PRAIRIE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052886",
            "telephone_number": "719-564-5070",
            "fax_number": "719-896-2874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Yale Pl",
            "address_purpose": "LOCATION",
            "city": "Canon City",
            "state": "CO",
            "postal_code": "812124611",
            "country_code": "US",
            "telephone_number": "719-275-0700",
            "fax_number": "719-896-2874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "AUDREY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0997843.NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0997843.NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "ANDERSON",
            "middle_name": "L.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.