Organization Active NPI

Advanced Gynecology Prof, LLC

  • Gynecology Physician
  • Colorado Springs, CO
National Provider Identifier
1871576512
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
ADVANCED GYNECOLOGY PROF, LLC
Practice address
5731 Silverstone Ter Ste 250
Colorado Springs, CO 80919-3545
Phone
(719) 633-8773
Fax
(719) 633-1905
NPI assigned
Nov 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Dr. Roy C Stringfellow, MDNPI 1407831720
Title
President
Phone
(719) 633-8773

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
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

5731 Silverstone Ter Ste 250
Colorado Springs, CO 80919-3545

Mailing address

5731 Silverstone Ter Ste 250
Colorado Springs, CO 80919-3545
Phone (719) 633-8773

Other identifiers 1

IdentifierTypeStateIssuer
41885244MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040206000565 CO Part B Supplier - Clinic/Group Practice 2163315698 Receives reassigned benefits from 4 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

2222 N Nevada Ave
Ste 4003
Colorado Springs, CO 80907
Phone (719) 633-5797

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1871576512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5731 SILVERSTONE TER STE 250",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193545",
            "telephone_number": "719-633-8773",
            "fax_number": "719-633-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5731 SILVERSTONE TER STE 250",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193545",
            "telephone_number": "719-633-8773",
            "fax_number": "719-633-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GYNECOLOGY PROF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "STRINGFELLOW",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-633-8773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41885244",
            "state": "CO"
        }
    ],
    "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 Oct 30, 2024; 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.