Individual provider Active NPI

Kezia Anne Hagiwara, FNP-C

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1679126072
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0994813 Issued in CO
Practice address
225 S Union Blvd
Colorado Springs, CO 80910-3184
Phone
(719) 632-5700
NPI assigned
Jul 24, 2019
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0994813 CO Primary

Addresses

Primary practice location

225 S Union Blvd
Colorado Springs, CO 80910-3184

Mailing address

1202 Pike Dr
Colorado Springs, CO 80904-1229
Phone (719) 332-9978

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
I20210311000620 CO Practitioner - Nurse Practitioner 6800202185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 E Boulder
Colorado Springs, CO 80909-5533
Phone (719) 776-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0994813COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Obstetrics & Gynecology PC CurrentSince Feb 24, 2021 Accepting new patients
Peak Vista Community Health Centers CurrentSince Apr 22, 2024 Accepting new patients
Peak Vista Community Health Centers CurrentSince Apr 22, 2024 Accepting new patients
Peak Vista Community Health Centers Past Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

225 S Union Blvd
Colorado Springs, CO 80910
Phone (719) 344-6304

225 S Union Blvd
Ste 2
Colorado Springs, CO 80910
Phone (719) 344-6617

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

8580 Scarborough Dr
Ste 100
Colorado Springs, CO 80920
Phone (719) 596-3344

Interoperability endpoints

  • Direct secure messaging: kezia.hagiwara.p1@direct.peakvista.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1679126072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 PIKE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809041229",
            "telephone_number": "719-332-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S UNION BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103184",
            "telephone_number": "719-632-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGIWARA",
        "first_name": "KEZIA",
        "middle_name": "ANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0994813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.