Individual provider Active NPI

Katie Moore Grose, NP

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1679165955
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0996050 Issued in CO
Practice address
3920 N Union Blvd Ste 220
Colorado Springs, CO 80907-4920
Phone
(719) 375-5400
Fax
(719) 434-7474
NPI assigned
Feb 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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 0996050 CO Primary

Addresses

Primary practice location

3920 N Union Blvd Ste 220
Colorado Springs, CO 80907-4920

Mailing address

3920 N Union Blvd Ste 220
Colorado Springs, CO 80907-4920
Phone (719) 375-5400

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
I20210302001634 CO Practitioner - Nurse Practitioner 2466868245 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0996050COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Colorado, LLC Family CurrentSince Mar 17, 2021 Accepting new patients
Colorado Springs Pain Consultants LLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

3920 N Union Blvd
Ste 220
Colorado Springs, CO 80907
Phone (719) 375-5400

3920 N Union Blvd
Ste 240
Colorado Springs, CO 80907
Phone (719) 227-9711

1750 W Uintah St
Colorado Springs, CO 80904
Phone (719) 325-0344

2955 Professional Pl
Ste 100
Colorado Springs, CO 80904
Phone (719) 375-5400

3620 Austin Bluffs Pkwy
Colorado Springs, CO 80918
Phone (719) 325-0342

7984 W Alameda Ave
Lakewood, CO 80226
Phone (303) 459-7105

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1679165955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 N UNION BLVD STE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074920",
            "telephone_number": "719-375-5400",
            "fax_number": "719-434-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 N UNION BLVD STE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074920",
            "telephone_number": "719-375-5400",
            "fax_number": "719-434-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSE",
        "first_name": "KATIE",
        "middle_name": "MOORE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0996050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.