Active NPI
Sandy G Castellucci
- Nurse Practitioner
- Colorado Springs, CO
National Provider Identifier
1700806163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 99472
- Practice address
- 301 S Union Blvd
Epch Dept
Colorado Springs, CO 80910 - Phone
- (719) 575-8613
- Fax
- (719) 575-8629
- NPI assigned
- Jul 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 99472 | CO | Primary |
Addresses
Primary practice location
301 S Union Blvd
Epch Dept
Colorado Springs, CO 80910
Mailing address
3159 Spotted Tail Drive
Colorado Springs, CO 80916
Phone (719) 386-0880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99472 | CO | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700806163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3159 SPOTTED TAIL DRIVE",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80916",
"telephone_number": "719-386-0880",
"fax_number": "719-575-8629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S UNION BLVD",
"address_2": "EPCH DEPT",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80910",
"telephone_number": "719-575-8613",
"fax_number": "719-575-8629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTELLUCCI",
"first_name": "SANDY",
"middle_name": "G",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "99472",
"primary": true
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.