Alicia Ruth Souvignier, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2934 Issued in NM

Practice address

1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604

Phone

(719) 524-5218

NPI assigned

Oct 14, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1679562417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 STONEHAVEN DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064835",
            "telephone_number": "505-215-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR UNIT MEDDAC",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-524-5218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "US Hwy 491 North",
            "address_purpose": "LOCATION",
            "city": "Shiprock",
            "state": "NM",
            "postal_code": "87420",
            "country_code": "US",
            "telephone_number": "505-368-6401",
            "fax_number": "505-368-6431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUVIGNIER",
        "first_name": "ALICIA",
        "middle_name": "RUTH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "2934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97451070",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "927981",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21272263",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Solak, MD, MPH
• Matthew Solomon, DO
• Joshua Brown Somma, PA-C
• Young-Hee Song, ANP, CHN-CNS
• Mario Soto, M.D.
• Sean Michael Spanbauer
• Dale A Spence, PA-C
• Steven L. Spoonemore Jr., PT
• Leslie Karen Spry, PHARM.D., MBA
• Melissa Spurling, PHARM.D.

• Physical Therapist in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.