Individual provider Active NPI

Thomas Higginbotham

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1962502567
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
27563 Issued in CO
Practice address
1430 S 21St St
Ste 101
Colorado Springs, CO 80904-4225
Phone
(719) 260-8190
Fax
(719) 260-6086
NPI assigned
Sep 24, 2006
Last updated
Nov 1, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 27563 CO Primary

Addresses

Primary practice location

1430 S 21St St
Ste 101
Colorado Springs, CO 80904-4225

Mailing address

1430 S 21St St
Ste 101
Colorado Springs, CO 80904-4225
Phone (719) 260-8190

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
I20080521000323 CO Practitioner - Preventive MedicinePractitioner - General PracticePractitioner - Osteopathic Manipulative Medicine 9032288725 Practice locations: Colorado Springs, CO

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27563COMDPreventive Medicine/Occupational Environmental Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1962502567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 S 21ST ST",
            "address_2": "STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809044225",
            "telephone_number": "719-260-8190",
            "fax_number": "719-260-6086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 S 21ST ST",
            "address_2": "STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809044225",
            "telephone_number": "719-260-8190",
            "fax_number": "719-260-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CO",
            "license": "27563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.