Individual provider Active NPI

Colleen Savage, DNP

  • Family Nurse Practitioner
  • Lake Havasu City, AZ
National Provider Identifier
1790103711
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP5630 Issued in AZ
Practice address
2090 Smoketree Ave N
Lake Havasu City, AZ 86403-5806
Phone
(928) 854-1800
NPI assigned
Apr 7, 2014
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN088300 AZ
Family Nurse Practitioner 363LF0000X AP5630 AZ Primary

Addresses

Primary practice location

2090 Smoketree Ave N
Lake Havasu City, AZ 86403-5806

Mailing address

PO Box 3630
Flagstaff, AZ 86003-3630

Other practice location 1

1980 Mesquite Ave
Lake Havasu City, AZ 86403-7713
Phone (928) 680-1919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20171101002656 AZ Practitioner - Nurse Practitioner 6507122892 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN088300AZMDRegistered Nurse
AP5630AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. CurrentSince Dec 1, 2017 Accepting new patients
North Country Healthcare, Inc. CurrentSince Dec 1, 2017 Accepting new patients
North Country Healthcare, Inc. Past Accepting new patients
Havasu Rainbow Pediatrics Past Accepting new patients

Locations

2585 Miracle Mile
Ste 116
Bullhead City, AZ 86442
Phone (928) 219-3300

2500 N Rose St
Flagstaff, AZ 86004
Phone (928) 213-6121

2090 Smoketree Ave N
Lk Havasu Cty, AZ 86403
Phone (928) 854-1800

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1790103711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3630",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860033630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 SMOKETREE AVE N",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035806",
            "telephone_number": "928-854-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1980 Mesquite Ave",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864037713",
            "country_code": "US",
            "telephone_number": "928-680-1919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAVAGE",
        "first_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN088300",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.