Individual provider Active NPI

Elesa L Ignowski

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1942685151
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
76904 Issued in KS
Practice address
1750 W Uintah St
Colorado Springs, CO 80904-2926
Phone
(719) 325-0344
NPI assigned
Jul 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 92861 KS
Family Nurse Practitioner 363LF0000X 0993073 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 76904 KS Primary

Addresses

Primary practice location

1750 W Uintah St
Colorado Springs, CO 80904-2926

Mailing address

2620 Elm Hill Pike
Nashville, TN 37214-3108
Phone (615) 425-4200

Other names 1

  • Elesa L Fetters Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, CO2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20151109002005 KS Practitioner - Nurse Practitioner 3971813650 Reassigns benefits to 1 organization
I20170601000719 CO Practitioner - Nurse Practitioner 3971813650 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Soma Recovery LLCGroup PAC ID 7810387339, 31 clinicians

Practice addresses (Care Compare)

825 N Waco Ave
Wichita, KS 67203-3939
Phone (316) 201-6047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0993073COMDFamily Nurse Practitioner
92861KSMDFamily Nurse Practitioner
76904KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Jul 30, 2021 Accepting new patients
The Little Clinic of Colorado, LLC Family CurrentSince May 3, 2017 Accepting new patients
Soma Recovery LLC CurrentSince Jul 15, 2022 Accepting new patients
Peak Vista Community Health Centers CurrentSince Jul 30, 2021 Accepting new patients

Locations

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

1750 W Uintah St
Colorado Springs, CO 80904
Phone (719) 325-0344

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

1070 W Baptist Rd
Colorado Springs, CO 80921
Phone (719) 487-6050

7984 W Alameda Ave
Lakewood, CO 80226
Phone (303) 459-7105

825 N Waco Ave
Ste 200
Wichita, KS 67203
Phone (316) 201-6047

825 N Waco Ave
Wichita, KS 67203
Phone (316) 201-6047

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

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": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1942685151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108",
            "telephone_number": "615-425-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 W UINTAH ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809042926",
            "telephone_number": "719-325-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGNOWSKI",
        "first_name": "ELESA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-29",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "92861",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0993073",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "76904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELESA",
            "last_name": "FETTERS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.