NPIMap

Individual provider Active NPI

Kimberly Lue Wagner, MD

  • Neurology Physician
  • Colorado Springs, CO
National Provider Identifier
1922325497
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DR.0053519 Issued in CO
Practice address
5825 Delmonico Dr Ste 102
Colorado Springs, CO 80919-2243
Phone
(719) 715-4882
Fax
(303) 381-1566
NPI assigned
Apr 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DR.0053519 CO Primary

Addresses

Primary practice location

5825 Delmonico Dr Ste 102
Colorado Springs, CO 80919-2243

Mailing address

5825 Delmonico Dr Ste 102
Colorado Springs, CO 80919-2243
Phone (303) 381-0929

Other practice location 1

11700 W 2nd Pl Ste 255
Lakewood, CO 80228-1707
Phone (720) 321-8040

Other identifiers 1

IdentifierTypeStateIssuer
03254356MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140818002309 CO Practitioner - Neurology 7911124722 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Neurology of the Rockies LLCGroup PAC ID 7315962008, 11 clinicians

Practice addresses (Care Compare)

1400 E Boulder
Suite 2410 Pre Procedure Memorial
Colorado Springs, CO 80909-5533
Phone (719) 365-6525

1400 E Boulder St
Colorado Springs, CO 80909-5533

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

4050 Briargate Pkwy
Colorado Springs, CO 80920-7815

4080 Briargate Pkwy
Colorado Springs, CO 80920-7815
Phone (719) 365-6800

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

5825 Delmonico Dr
Suite 102
Colorado Springs, CO 80919-2243
Phone (303) 381-0929

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0053519COMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince May 6, 2016 Accepting new patients
Colorado Springs Neurological Associates, PC CurrentSince Aug 1, 2014 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Apr 1, 2017 Accepting new patients
Colorado Springs Neurological Associates, PC Neurology CurrentSince Aug 1, 2014 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince May 6, 2016 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Apr 1, 2017 Accepting new patients
Purple Mountain Recovery Inc Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Purple Mountain Recovery Inc Past Accepting new patients

Locations

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

9100 E Mineral Cir
Fl 2
Centennial, CO 80112
Phone (303) 673-8075

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

4110 Briargate Pkwy
Ste 405
Colorado Springs, CO 80920
Phone (719) 365-7300

2312 N Nevada Ave
Ste 100
Colorado Springs, CO 80907
Phone (719) 389-1108

4110 Briargate Pkwy
Ste 140
Colorado Springs, CO 80920
Phone (719) 365-7300

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

11750 W 2nd Pl
Ste 255
Lakewood, CO 80228
Phone (303) 629-5600

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

Organizations & group practices 11

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1922325497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 DELMONICO DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809192243",
            "telephone_number": "303-381-0929",
            "fax_number": "303-381-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 DELMONICO DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809192243",
            "telephone_number": "719-715-4882",
            "fax_number": "303-381-1566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11700 W 2nd Pl Ste 255",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281707",
            "country_code": "US",
            "telephone_number": "720-321-8040",
            "fax_number": "720-321-8041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KIMBERLY",
        "middle_name": "LUE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0053519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03254356",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.