Individual provider Active NPI

Leah Diane Bork, RN

  • General Practice Registered Nurse
  • Colorado Springs, CO
National Provider Identifier
1760212120
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN.0102514 Issued in CO
Practice address
3470 Centennial Blvd Ste 205
Colorado Springs, CO 80907-8669
Phone
(719) 598-4588
Fax
(719) 594-4067
NPI assigned
Aug 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN.0102514 CO Primary

Addresses

Primary practice location

3470 Centennial Blvd Ste 205
Colorado Springs, CO 80907-8669

Mailing address

3470 Centennial Blvd Ste 205
Colorado Springs, CO 80907-8669
Phone (719) 598-4588

Other practice location 1

1633 Medical Center Pt
Colorado Springs, CO 80907-5700
Phone (719) 598-9446

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.0102514COMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1760212120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3470 CENTENNIAL BLVD STE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078669",
            "telephone_number": "719-598-4588",
            "fax_number": "719-594-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3470 CENTENNIAL BLVD STE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078669",
            "telephone_number": "719-598-4588",
            "fax_number": "719-594-4067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1633 Medical Center Pt",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809075700",
            "country_code": "US",
            "telephone_number": "719-598-9446",
            "fax_number": "719-598-5734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORK",
        "first_name": "LEAH",
        "middle_name": "DIANE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CO",
            "license": "RN.0102514",
            "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 Aug 1, 2024; 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.