Organization Active NPI

Colorado Springs Neurological Associates, PC

  • Clinical Neuropsychologist
  • Colorado Springs, CO
National Provider Identifier
1912645458
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
COLORADO SPRINGS NEUROLOGICAL ASSOCIATES, PC
Practice address
2312 N Nevada Ave Ste 100
Colorado Springs, CO 80907-5307
Phone
(719) 473-3272
Fax
(719) 389-1191
NPI assigned
May 24, 2022
Organization subpart
Yes
Parent organization
COLORADO SPRINGS NEUROLOGICAL ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Authorized official

Name
Mary Frailey
Title
HR
Phone
(719) 389-1108

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X

Addresses

Primary practice location

2312 N Nevada Ave Ste 100
Colorado Springs, CO 80907-5307

Mailing address

2312 N Nevada Ave Ste 100
Colorado Springs, CO 80907-5307
Phone (719) 473-3272

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000213 CO Part B Supplier - Clinic/Group Practice 9638073612 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colorado Springs, CO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Colo SPGS Neurological

Locations

5725 Mark Dabling Blvd
Ste 100
Colorado Springs, CO 80919
Phone (719) 473-3272

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1912645458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 N NEVADA AVE STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075307",
            "telephone_number": "719-473-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 N NEVADA AVE STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075307",
            "telephone_number": "719-473-3272",
            "fax_number": "719-389-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPRINGS NEUROLOGICAL ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO SPRINGS NEUROLOGICAL ASSOCIATES, PC",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "FRAILEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "HR",
        "authorized_official_telephone_number": "719-389-1108"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 May 24, 2022; 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.