Active NPI
Cynthia Lawther Custer, NP
- Women's Health Nurse Practitioner
- Colorado Springs, CO
National Provider Identifier
1710914452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 91792
- Practice address
- 1330 W Colorado Ave
Colorado Springs, CO 80904-4023 - Phone
- (719) 475-7162
- Fax
- (719) 475-2201
- NPI assigned
- Jun 27, 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 91792 | CO | Primary |
Addresses
Primary practice location
1330 W Colorado Ave
Colorado Springs, CO 80904-4023
Mailing address
910 Summer Games Dr
Colorado Springs, CO 80906-1381
Phone (719) 389-1417
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 230 | Medicaid | CO |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91792 | CO | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710914452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 SUMMER GAMES DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809061381",
"telephone_number": "719-389-1417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 W COLORADO AVE",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809044023",
"telephone_number": "719-475-7162",
"fax_number": "719-475-2201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUSTER",
"first_name": "CYNTHIA",
"middle_name": "LAWTHER",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CO",
"license": "91792",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "230",
"state": "CO"
}
],
"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.