| Rivendell Health Pc | |
|
1465 Kelly Johnson Blvd Ste 310 Colorado Springs CO 80920-3947 | |
| (719) 726-6573 | |
| Not Available |
| Full Name | Rivendell Health Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1465 Kelly Johnson Blvd Ste 310, Colorado Springs, Colorado |
| Authorized Official Name and Position | Michael R Fry (PRESIDENT) |
| Authorized Official Contact | 7197266573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivendell Health Pc 1465 Kelly Johnson Blvd Ste 310 Colorado Springs CO 80920-3947 Ph: (719) 726-6573 | Rivendell Health Pc 1465 Kelly Johnson Blvd Ste 310 Colorado Springs CO 80920-3947 Ph: (719) 726-6573 |
| NPI Number | 1730927567 |
|---|---|
| Provider Enumeration Date | 07/16/2024 |
| Last Update Date | 07/16/2024 |
| Medicare PECOS PAC ID | 1052851433 |
|---|---|
| Medicare Enrollment ID | O20240912000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730927567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Michael Reed Fry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285011577 PECOS PAC ID: 1951617190 Enrollment ID: I20230705000504 |
| Provider Name | Joshua James |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285121780 PECOS PAC ID: 3577928472 Enrollment ID: I20231207000752 |
Amazing Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5777 N Academy Blvd, Colorado Springs, CO 80918 Phone: 719-266-5800 Fax: 719-960-2039 | |
Kids Are Great Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 E Fontanero St, Suite 308, Colorado Springs, CO 80907 Phone: 719-577-4200 Fax: 719-442-6595 | |
Dcs Internal Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5550 Vessey Rd, Colorado Springs, CO 80908 Phone: 623-680-0539 | |
Pikes Peak Discharge Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2920 N Cascade Ave Fl 2, Colorado Springs, CO 80907 Phone: 719-247-2532 | |
Northwest Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5390 N Academy Blvd, #300, Colorado Springs, CO 80918 Phone: 719-884-1210 | |