NPIMap

Organization Active NPI

Peak Vista Community Health Centers

Doing business as Peak Vista Pharmacy at Union

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
National Provider Identifier
1700834272
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PEAK VISTA COMMUNITY HEALTH CENTERS
Doing business as
Peak Vista Pharmacy at Union
Practice address
225 S Union
Garden Level
Colorado Springs, CO 80910
Phone
(719) 632-5700
Fax
(719) 228-6655
NPI assigned
May 5, 2006
Last updated
Dec 12, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PEAK VISTA COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Authorized official

Name
Bradach Fitzwater
Title
Cfo
Phone
(719) 344-6188

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X CO Primary
Pharmacy 333600000X NU

Addresses

Primary practice location

225 S Union
Garden Level
Colorado Springs, CO 80910

Mailing address

3205 N Academy Blvd
Suite 130
Colorado Springs, CO 80917
Phone (719) 344-6914

Other identifiers 1

IdentifierTypeStateIssuer
03000221MedicaidCO

Other names 1

  • Peak Vista Pharmacy at Union Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center27 organizations share this tax ID, including this one
Part of
Community Health Center

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1700834272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD",
            "address_2": "SUITE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80917",
            "telephone_number": "719-344-6914",
            "fax_number": "719-344-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S UNION",
            "address_2": "GARDEN LEVEL",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80910",
            "telephone_number": "719-632-5700",
            "fax_number": "719-228-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK VISTA COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEAK VISTA COMMUNITY HEALTH CENTER",
        "enumeration_date": "2006-05-05",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "FITZWATER",
        "authorized_official_first_name": "BRADACH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "719-344-6188"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CO",
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03000221",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Vista Pharmacy at Union",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 12, 2016; 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.