NPIMap

Organization Active NPI

Impact Psychiatric Care, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1871035543
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
IMPACT PSYCHIATRIC CARE, LLC
Practice address
2993 Broadmoor Valley Rd Ste 103
Colorado Springs, CO 80906-4471
Phone
(719) 301-7731
NPI assigned
Nov 13, 2016
Last updated
Apr 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Authorized official

Name
Natalie Erb, PMHNP-BC, LCSWNPI 1457736266
Title
Partner
Phone
(719) 301-7731

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 Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

2993 Broadmoor Valley Rd Ste 103
Colorado Springs, CO 80906-4471

Mailing address

PO Box 7035
Surprise, AZ 85374-0100
Phone (719) 301-7731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170503000259 CO Part B Supplier - Clinic/Group Practice 3870870710 Receives reassigned benefits from 9 practitioners
Practice locations: Colorado Springs, CO
O20240206000051 FL Part B Supplier - Clinic/Group Practice 3870870710 Receives reassigned benefits from 2 practitioners
Practice locations: Homosassa, FL

National Provider Directory

National Provider Directory

Locations

2993 Broadmoor Valley Rd
Ste 103
Colorado Springs, CO 80906
Phone (719) 301-7731

2993 Broadmoor Valley Rd
Ste 105A
Colorado Springs, CO 80906
Phone (719) 301-7731

2993 Broadmoor Valley Rd
Ste 207
Colorado Springs, CO 80906
Phone (719) 301-7731

6510 S Academy Blvd
Ste 291A
Colorado Springs, CO 80906

Practitioners & affiliated clinicians

Practitioners 10

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": "1478995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1871035543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7035",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853740100",
            "telephone_number": "719-301-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2993 BROADMOOR VALLEY RD STE 103",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064471",
            "telephone_number": "719-301-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PSYCHIATRIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-13",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "ERB",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "719-301-7731",
        "authorized_official_credential": "PMHNP-BC, LCSW"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "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 Apr 12, 2021; 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.