Individual provider Active NPI

Allen C Kwilman, M.D.

  • Emergency Medicine Physician
National Provider Identifier
1831177757
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
32775 Issued in CO
Practice address
Each
1650 Cochrane Circle
Apo, AA 80913
Phone
(719) 526-7967
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 32775 CO Primary

Addresses

Primary practice location

Each
1650 Cochrane Circle
Apo, AA 80913

Mailing address

1650 Cochrane Cir Unit Meddac
Colorado Springs, CO 80913-4604
Phone (719) 526-7967

Other identifiers 1

IdentifierTypeStateIssuer
01327758MedicaidCO

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000263 CO Practitioner - Emergency Medicine 9234267279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Southern California Keck School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2500 Fairway St
Dickinson, ND 58601-2639

4265 45TH St S
Suite 200
Fargo, ND 58104-4309

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32775COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prowers County Hospital District CurrentSince Mar 3, 2019 Accepting new patients
Longs Peak Emergency Physicians, PC Emergency Medicine Past Accepting new patients

Locations

401 Kendall Dr
Lamar, CO 81052
Phone (719) 336-4343

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.

Hospital & facility affiliations 1

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1831177757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR UNIT MEDDAC",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "EACH",
            "address_2": "1650 COCHRANE CIRCLE",
            "city": "APO",
            "state": "AA",
            "postal_code": "80913",
            "telephone_number": "719-526-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWILMAN",
        "first_name": "ALLEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "32775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01327758",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.