NPIMap

Individual provider Active NPI

Michele Ann Gatheridge, M.D.

  • Neurology Physician
  • Colorado Springs, CO
National Provider Identifier
1952543555
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
CDRH.0059764 Issued in CO
Practice address
5818 N Nevada Ave Ste 225
Colorado Springs, CO 80918-3547
Phone
(719) 365-3740
Fax
(719) 365-3741
NPI assigned
Mar 27, 2009
Last updated
Mar 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DR.0059764 CO
Neurology Physician 2084N0400X CDRH.0059764 CO Primary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X DR.0059764 CO
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X CDRH.0059764 CO

Addresses

Primary practice location

5818 N Nevada Ave Ste 225
Colorado Springs, CO 80918-3547

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2412

Other practice location 1

5770 Flintridge Dr Ste 100
Colorado Springs, CO 80918-1870
Phone (719) 445-9902

Other practice location 2

Brooke Army Medical Center
3551 Roger Brooke Drive
JBSA Fort Sam Houston, TX 78234-4504
Phone (210) 916-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180917001161 CO Practitioner - NeurologyPractitioner - Neuropsychiatry 6406107358 Reassigns benefits to 2 organizations
I20200629000213 OK Practitioner - Neurology 6406107358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
George Washington University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peak Neurology Corp PCGroup PAC ID 0042592339, 7 clinicians
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

5770 Flintridge Dr
Suite 100
Colorado Springs, CO 80918-1870
Phone (719) 445-9902

5818 N Nevada Ave
Suite 225
Colorado Springs, CO 80918-3547
Phone (719) 365-7630

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jun 29, 2020 Accepting new patients
Peak Neurology Corp PC Neurology CurrentSince Jun 19, 2019 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
St. John Physicians, Inc. Neurology CurrentSince Jun 29, 2020 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Apr 24, 2023 Accepting new patients
Peak Neurology Corp PC Neurology CurrentSince Dec 7, 2025 Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

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

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

4110 Briargate Pkwy
Ste 405
Colorado Springs, CO 80920
Phone (719) 364-0160

5770 Flintridge Dr
Ste 100
Colorado Springs, CO 80918
Phone (719) 445-9902

3464 S Willow St
Ste 10
Denver, CO 80231

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

2000 S Wheeling Ave
Ste 701
Tulsa, OK 74104
Phone (918) 744-7887

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1952543555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5818 N NEVADA AVE STE 225",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183547",
            "telephone_number": "719-365-3740",
            "fax_number": "719-365-3741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5770 Flintridge Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809181870",
            "country_code": "US",
            "telephone_number": "719-445-9902",
            "fax_number": "719-387-0312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Brooke Army Medical Center",
            "address_2": "3551 Roger Brooke Drive",
            "address_purpose": "LOCATION",
            "city": "JBSA Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GATHERIDGE",
        "first_name": "MICHELE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0059764",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "CDRH.0059764",
            "primary": true
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "CO",
            "license": "DR.0059764",
            "primary": false
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "CO",
            "license": "CDRH.0059764",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.