Front Range Family Medicine | |
3260 E Woodmen Rd Suite 210 Colorado Springs CO 80920-3587 | |
(719) 262-0852 | |
(719) 262-0853 |
Full Name | Front Range Family Medicine |
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Speciality | Family Medicine |
Location | 3260 E Woodmen Rd, Colorado Springs, Colorado |
Authorized Official Name and Position | Brad J Reedy (OWNER) |
Authorized Official Contact | 7192620852 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Front Range Family Medicine 3260 E Woodmen Rd Suite 210 Colorado Springs CO 80920-3587 Ph: (719) 262-0852 | Front Range Family Medicine 3260 E Woodmen Rd Suite 210 Colorado Springs CO 80920-3587 Ph: (719) 262-0852 |
NPI Number | 1528275906 |
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Provider Enumeration Date | 05/16/2007 |
Last Update Date | 08/13/2007 |
Medicare PECOS PAC ID | 4880642396 |
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Medicare Enrollment ID | O20050113001053 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528275906 | NPI | - | NPPES |
40494 | Other | CO | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 40494 (Colorado) | Primary |
Provider Name | Brad J Reedy |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1164519443 PECOS PAC ID: 5294783718 Enrollment ID: I20050111000544 |
Provider Name | Marcia L Ellis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811026610 PECOS PAC ID: 1456424753 Enrollment ID: I20080721000074 |
Provider Name | Bridget Lynn Lee |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639445182 PECOS PAC ID: 7810207271 Enrollment ID: I20161229000062 |
Provider Name | Melissa Kranz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861068710 PECOS PAC ID: 9739589987 Enrollment ID: I20210715002263 |
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