Individual provider Active NPI

Luke James McCarthy, RN

  • Gerontology Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1881153146
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
C-APN.0003606-C-NP Issued in CO
Practice address
1725 E Boulder St Ste 101
Colorado Springs, CO 80909-5740
Phone
(719) 365-6300
NPI assigned
Mar 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-166190 AL
Gerontology Nurse Practitioner 363LG0600X C-APN.0003606-C-NP CO Primary

Addresses

Primary practice location

1725 E Boulder St Ste 101
Colorado Springs, CO 80909-5740

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, CO, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20211025002782 AL Practitioner - Nurse Practitioner 8224426267 Reassigns benefits to 1 organization
I20220425001898 CO Practitioner - Nurse Practitioner 8224426267 Reassigns benefits to 1 organization
I20241001002340 FL Practitioner - Nurse Practitioner 8224426267 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-APN.0003606-C-NPCOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Apr 15, 2022 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jul 21, 2021 Accepting new patients
Family Spine and Pain Care Institute LLC CurrentSince Sep 18, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Apr 15, 2022 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

1802 6th Ave S
Birmingham, AL 35233
Phone (205) 934-5105

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1725 E Boulder St
Ste 101
Colorado Springs, CO 80909
Phone (719) 365-6300

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1525 Tamiami Trl S
Ste 601
Venice, FL 34285
Phone (813) 495-8011

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20709/brand/1/csg/1/fhir/r4

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": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1881153146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E BOULDER ST STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095740",
            "telephone_number": "719-365-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "LUKE",
        "middle_name": "JAMES",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-17",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-166190",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "C-APN.0003606-C-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.