Rivendell Health PC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

RIVENDELL HEALTH PC

Practice address

1465 Kelly Johnson Blvd Ste 310
Colorado Springs, CO 80920-3947

Phone

(719) 726-6573

NPI assigned

Jul 16, 2024

Last updated

Jul 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael R Fry, DONPI 1285011577

Title

President

Phone

(719) 726-6573

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Reed Fry, DO

  • Hospitalist Physician
  • Colorado Springs, CO
  • NPI 1285011577
  Medicare reassignment Care Compare group NPD Authorized official
• Joshua James, MD

  • Psychiatry Physician
  • New Braunfels, TX
  • NPI 1285121780

  CO

  Medicare reassignment Care Compare group NPD
• Madeleine Nelson

  • Physician Assistant
  • Colorado Springs, CO
  • NPI 1144929969
  Medicare reassignment Care Compare group
• Celeste Snediker, PA-C

  • Physician Assistant
  • Colorado Springs, CO
  • NPI 1134886591
  Medicare reassignment NPD
• Brittany Ann Omer, FNP-C

  • Family Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1003578873
  Medicare reassignment

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1730927567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 310",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203947",
            "telephone_number": "719-726-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 310",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203947",
            "telephone_number": "719-726-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVENDELL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-726-6573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Rivalsky
• Susan D Rivard, D.C.
• Rivas Chiropractic PLLC (Colorado Springs Spine and Injury)
• Erica H Rivas
• Rodolfo Rivas Jr., D.C.
• River of Life Counseling LLC
• River of Life Counseling LLC
• River of Life Counseling LLC
• River Valley Dental Hygiene, LLC
• Vivien Forrest River

• Multi-Specialty Clinic/Center in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Multi-Specialty Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.