Individual provider Active NPI

Nicola Suzanne Gray, PNP-AC

  • Pediatric Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1851832232
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
C-APN.0001417.NP Issued in CO
Practice address
4090 Briargate Pkwy
Colorado Springs, CO 80920-7815
Phone
(720) 777-5211
NPI assigned
Mar 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X C-APN.0001417.NP CO
Pediatric Nurse Practitioner 363LP0200X C-APN.0001417.NP CO Primary

Addresses

Primary practice location

4090 Briargate Pkwy
Colorado Springs, CO 80920-7815

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

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
I20191004000094 CO Practitioner - Nurse Practitioner 9032478201 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-APN.0001417.NPCOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated Nurse Practitioner CurrentSince Sep 1, 2019 Accepting new patients
University Physicians, Incorporated CurrentSince Sep 1, 2019 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
Children'S Hospital Colorado Past Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

6001 E Woodmen Rd
Colorado Springs, CO 80923
Phone (719) 571-1000

4090 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 305-1234

4050 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 364-5000

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

Dept 1061
Denver, CO 80256

Interoperability endpoints

  • Direct secure messaging: ngray201478@direct.childrenscolorado.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1851832232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4090 BRIARGATE PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207815",
            "telephone_number": "720-777-5211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-777-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "NICOLA",
        "middle_name": "SUZANNE",
        "credential": "PNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-17",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "C-APN.0001417.NP",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "C-APN.0001417.NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.