NPIMap

Organization Active NPI

Springs Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1801471982
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SPRINGS BEHAVIORAL HEALTH LLC
Practice address
1465 Kelly Johnson Blvd Ste 305
Colorado Springs, CO 80920-3947
Phone
(719) 495-3359
Fax
(719) 691-7003
NPI assigned
Mar 10, 2021
Last updated
Jan 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Authorized official

Name
Dr. Omar Ahmed Khan, DNPNPI 1629308135
Title
Ceo
Phone
(719) 495-3359

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1465 Kelly Johnson Blvd Ste 305
Colorado Springs, CO 80920-3947

Mailing address

1465 Kelly Johnson Blvd Ste 305
Colorado Springs, CO 80920-3947
Phone (719) 495-3359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210505000863 CO Part B Supplier - Clinic/Group Practice 8820407703 Receives reassigned benefits from 6 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

1465 Kelly Johnson Blvd
Ste 245
Colorado Springs, CO 80920

1465 Kelly Johnson Blvd
Ste 305
Colorado Springs, CO 80920
Phone (719) 362-0796

1880 Office Club Pt
Ste 245
Colorado Springs, CO 80920
Phone (520) 310-5265

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1801471982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 305",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203947",
            "telephone_number": "719-495-3359",
            "fax_number": "719-691-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 305",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203947",
            "telephone_number": "719-495-3359",
            "fax_number": "719-691-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGS BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "AHMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "719-495-3359",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "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 Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.