Individual provider Active NPI

Marisa K Phillips, NP

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1770712648
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-10041 Issued in CO
Practice address
3676 Parker Blvd
Pueblo, CO 81008-2212
Phone
(719) 553-2206
Fax
(719) 553-2226
NPI assigned
Jul 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP-10041 CO Primary

Addresses

Primary practice location

3676 Parker Blvd
Pueblo, CO 81008-2212

Mailing address

5108 Athos CT
Pueblo, CO 81005-1418
Phone (719) 564-9565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100903000732 CO Practitioner - Nurse Practitioner 7719001247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11600 W 2ND PL
Lakewood, CO 80228-1527
Phone (720) 321-4161

2222 N Nevada Ave
Colorado Springs, CO 80907-6794
Phone (719) 776-5333

6001 E Woodman Rd
Colorado Springs, CO 80923-2601
Phone (719) 571-1476

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as group
Quality
91.15
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-10041COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince Apr 1, 2023 Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince Apr 1, 2023 Accepting new patients
Usacs of Colorado Inc CurrentSince Jun 7, 2018 Accepting new patients
Usacs of Colorado, Inc CurrentSince Jun 7, 2018 Accepting new patients

Locations

10860 New Allegiance Dr
Colorado Springs, CO 80921
Phone (719) 757-7000

2222 N Nevada Ave
Colorado Springs, CO 80907
Phone (719) 776-5333

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1770712648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 ATHOS CT",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810051418",
            "telephone_number": "719-564-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "719-553-2206",
            "fax_number": "719-553-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARISA",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "NP-10041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.