Individual provider Active NPI

Shannon Kerry Flood Nichols, DO

  • Maternal & Fetal Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1912971573
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
DR.0067191 Issued in CO
Practice address
6071 E Woodmen Rd Ste 440
Colorado Springs, CO 80923-2614
Phone
(719) 571-4590
Fax
(719) 571-4591
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X DR.0067191 CO Primary
Maternal & Fetal Medicine Physician 207VM0101X OP 60410163 WA
Obstetrics & Gynecology Physician 207V00000X 414 NE

Addresses

Primary practice location

6071 E Woodmen Rd Ste 440
Colorado Springs, CO 80923-2614

Mailing address

6071 E Woodmen Rd Ste 440
Colorado Springs, CO 80923-2614
Phone (719) 571-4590

Other identifiers 1

IdentifierTypeStateIssuer
9000196236MedicaidCO

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210909003775 CO Practitioner - Obstetrics/Gynecology 1355583246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

6071 E Woodmen Rd
440 Mfma Maternal Fetal
Colorado Springs, CO 80923-2614
Phone (719) 571-4590

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
414NEMDCounselor
OP 60410163WAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2021 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2021 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

6071 E Woodmen Rd
Ste 440
Colorado Springs, CO 80923
Phone (719) 571-4590

6071 E Woodmen Rd
Ste 425
Colorado Springs, CO 80923
Phone (719) 484-8930

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1912971573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6071 E WOODMEN RD STE 440",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809232614",
            "telephone_number": "719-571-4590",
            "fax_number": "719-571-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 E WOODMEN RD STE 440",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809232614",
            "telephone_number": "719-571-4590",
            "fax_number": "719-571-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOOD NICHOLS",
        "first_name": "SHANNON",
        "middle_name": "KERRY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CO",
            "license": "DR.0067191",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "WA",
            "license": "OP 60410163",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000196236",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.