Active NPI
Daniel P Bagwell, LMT
- Specialist
- Colorado Springs, CO
National Provider Identifier
1710382817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MT0016705
- Practice address
- 2620 Tenderfoot Hill St
Suite 200
Colorado Springs, CO 80906-8353 - Phone
- (719) 527-6747
- Fax
- (719) 531-0880
- NPI assigned
- Oct 31, 2014
- Last updated
- Oct 31, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MT0016705 | CO | Primary |
Addresses
Primary practice location
2620 Tenderfoot Hill St
Suite 200
Colorado Springs, CO 80906-8353
Mailing address
2226 Stafford Lane
Colorado Springs, CO 80909
Phone (678) 787-1886
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 |
|---|---|---|---|
| MT0016705 | CO | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414713600000",
"number": "1710382817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2226 STAFFORD LANE",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80909",
"telephone_number": "678-787-1886",
"fax_number": "719-531-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 TENDERFOOT HILL ST",
"address_2": "SUITE 200",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809068353",
"telephone_number": "719-527-6747",
"fax_number": "719-531-0880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGWELL",
"first_name": "DANIEL",
"middle_name": "P",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-31",
"last_updated": "2014-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "MT0016705",
"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 Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.