NPI 1659641900 · live from the CMS NPI Registry
Optumcare Colorado Medical Group LLC
Non-Pharmacy Dispensing Site in Colorado Springs, CO. National Provider Identifier 1659641900, active.
NPI record
| NPI | 1659641900 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Non-Pharmacy Dispensing Site 332900000X |
| Practice location | 1633 Medical Center PT, Colorado Springs, CO 80907 |
| Practice phone | 719-636-2999 |
| Mailing address | Po Box 35380, Las Vegas, NV 89133 |
| Enumerated | January 4, 2012 |
| Last updated | August 20, 2024 |
| Authorized official | Emily Castillo, Associate Director Credentialing |
| Other names | Optumcare Colorado Springs LLC; Davita Medical Group Colorado Springs LLC; Colorado Springs Health Partners LLC; Optum Colorado Springs |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | — |
| Dermatology, Dermatopathology | 207ND0900X | — |
| Family Medicine | 207Q00000X | — |
| Internal Medicine, Gastroenterology | 207RG0100X | — |
| Internal Medicine, Pulmonary Disease | 207RP1001X | — |
| Psychiatry & Neurology, Neurology | 2084N0400X | — |
| General Practice | 208D00000X | — |
| Non-Pharmacy Dispensing Site primary | 332900000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.