Parkside CT Group LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

31124 Issued in CO

Legal business name

PARKSIDE CT GROUP LLC

Practice address

215 Parkside Dr
Colorado Springs, CO 80910-3135

Phone

(719) 477-1033

Fax

(719) 477-1037

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. J. Thomas Crepps, M.D.

Title

M.D./Member

Phone

(719) 477-1033

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karl Paul Dittrich, M.D.

  • Vascular Surgery Physician
  • Colorado Springs, CO
  • NPI 1295715225
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700839248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 PARKSIDE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103135",
            "telephone_number": "719-477-1033",
            "fax_number": "719-477-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PARKSIDE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103135",
            "telephone_number": "719-477-1033",
            "fax_number": "719-477-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE CT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CREPPS",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "M.D./MEMBER",
        "authorized_official_telephone_number": "719-477-1033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CO",
            "license": "31124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "31124",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffery David Parkinson, MA DABNM
• Parkmoor Rehabilitation LLC
• Melissa Jean Parkowski-Helmer, LCSW
• Victoria Parks, RBT
• Parkside Cardiology LLC
• Parkside CT Group, LLC
• Craig Robert Parlet, D.D.S.
• Rebecca Jane Parlet, MS-CCC/SLP
• Amber Michelle Parmelee
• Stephanie A Parmenter

• Vascular Surgery Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Vascular Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.