Organization Active NPI

Surprise Valley Health and Wellness Inc

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1669246450
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SURPRISE VALLEY HEALTH AND WELLNESS INC
Practice address
1304 N Academy Blvd Ste 209
Colorado Springs, CO 80909-3318
Phone
(719) 888-7668
NPI assigned
Nov 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Helen-Elena EmegbaghaNPI 1518474469
Title
Owner
Phone
(719) 888-7668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1304 N Academy Blvd Ste 209
Colorado Springs, CO 80909-3318

Mailing address

3246 Centennial Blvd # 161
Colorado Springs, CO 80907-4077
Phone (719) 888-7668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240129000977 CO Part B Supplier - Clinic/Group Practice 2961855747 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory
Tax ID family
Surprise Valley Health and Wellness Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

417 Security Blvd
#B
Colorado Springs, CO 80911

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1669246450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3246 CENTENNIAL BLVD # 161",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074077",
            "telephone_number": "719-888-7668",
            "fax_number": "719-941-7306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 N ACADEMY BLVD STE 209",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093318",
            "telephone_number": "719-888-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURPRISE VALLEY HEALTH AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-13",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "EMEGBAGHA",
        "authorized_official_first_name": "HELEN-ELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-888-7668"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.