NPIMap

Organization Active NPI

Colorado Springs Orthopaedic Group

  • Specialist
  • Colorado Springs, CO
National Provider Identifier
1972578359
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COLORADO SPRINGS ORTHOPAEDIC GROUP
Practice address
4110 Briargate Parkway
Suite 300
Colorado Springs, CO 80920
Phone
(719) 632-7669
Fax
(719) 632-0088
NPI assigned
Feb 21, 2006
Last updated
Jun 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Mr. Kyle W.D. Nelson
Title
Ceo
Phone
(719) 867-7371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X CO Primary

Addresses

Primary practice location

4110 Briargate Parkway
Suite 300
Colorado Springs, CO 80920

Mailing address

4110 Briargate Parkway
Suite 300
Colorado Springs, CO 80920
Phone (719) 632-7669

Other practice location 1

6140 Tutt Blvd Ste 110
Colorado Springs, CO 80923-3577
Phone (719) 632-7669

Other identifiers 1

IdentifierTypeStateIssuer
04013603MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308000524 CO Part B Supplier - Clinic/Group Practice 5395633747 Receives reassigned benefits from 120 practitioners
1 other NPI on this enrollment
Practice locations: Colorado Springs, CO

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1259 Lake Plaza Dr
Colorado Springs, CO 80906
Phone (719) 333-5804

1655 Quail Lake Loop
Colorado Springs, CO 80906
Phone (719) 417-4931

4110 Briargate Pkwy
Ste 105
Colorado Springs, CO 80920

Practitioners & affiliated clinicians

Practitioners 123

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 123

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1972578359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PARKWAY",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80920",
            "telephone_number": "719-632-7669",
            "fax_number": "719-632-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PARKWAY",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80920",
            "telephone_number": "719-632-7669",
            "fax_number": "719-632-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6140 Tutt Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809233577",
            "country_code": "US",
            "telephone_number": "719-632-7669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLORADO SPRINGS ORTHOPAEDIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "W.D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "719-867-7371",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04013603",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.