Individual provider Active NPI

Stephanie Spies-Upton, PHD

  • Clinical Neuropsychologist
  • Colorado Springs, CO
National Provider Identifier
1801510524
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
7730 N Union Blvd Ste 105
Colorado Springs, CO 80920-4075
Phone
(719) 323-3094
NPI assigned
Sep 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0005956 CO
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

7730 N Union Blvd Ste 105
Colorado Springs, CO 80920-4075

Mailing address

605 Stubblefield Dr
Fountain, CO 80817-3118
Phone (936) 250-3032

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221021002238 CO Practitioner - Clinical Psychologist 1456727007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

2860 S Circle Dr
Colorado Springs, CO 80906-4195
Phone (719) 540-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY.0005956COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC CurrentSince Apr 23, 2024 Accepting new patients
Family Care Center, LLC Clinical CurrentSince Apr 23, 2024 Accepting new patients

Locations

2860 S Circle Dr
Ste 310
Colorado Springs, CO 80906

2860 S Circle Dr
Fl 4
Colorado Springs, CO 80906
Phone (719) 540-2146

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1801510524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 STUBBLEFIELD DR",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808173118",
            "telephone_number": "936-250-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 N UNION BLVD STE 105",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204075",
            "telephone_number": "719-323-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIES-UPTON",
        "first_name": "STEPHANIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0005956",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.