Individual provider Active NPI

Kaitlin Alexandra Veselicky, FNP

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1891276044
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F08180956 Issued in CO
Practice address
340 Printers Pkwy
Colorado Springs, CO 80910-3190
Phone
(719) 331-9645
NPI assigned
Aug 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08180956 CO Primary

Addresses

Primary practice location

340 Printers Pkwy
Colorado Springs, CO 80910-3190

Mailing address

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917-5152
Phone (719) 632-5700

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
I20181010002246 CO Practitioner - Nurse Practitioner 5193077634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

350 Printers Pkwy
Colorado Springs, CO 80910-3190
Phone (719) 632-5700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F08180956COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Sep 19, 2018 Accepting new patients
Peak Vista Community Health Centers CurrentSince Sep 19, 2018 Accepting new patients
Peak Vista Community Health Centers Past Accepting new patients

Locations

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

350 Printers Pkwy
Colorado Springs, CO 80910
Phone (719) 596-2020

430 Gold Pass Hts
Colorado Springs, CO 80906

410 Gold Pass Hts
Colorado Springs, CO 80906
Phone (719) 576-3326

340 Printers Pkwy
Colorado Springs, CO 80910
Phone (719) 228-6635

3205 N Academy Blvd
Ste 100
Colorado Springs, CO 80917
Phone (719) 776-3600

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

Interoperability endpoints

  • Direct secure messaging: kaitlin.veselicky.p1@direct.peakvista.nextgenshare.com

Organizations & group practices 3

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": "1535241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1891276044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD",
            "address_2": "STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175152",
            "telephone_number": "719-632-5700",
            "fax_number": "719-344-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 PRINTERS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103190",
            "telephone_number": "719-331-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESELICKY",
        "first_name": "KAITLIN",
        "middle_name": "ALEXANDRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-26",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "F08180956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.