Provider Type Icon

PIKES PEAK CENTER FOR COLON & RECTAL SURGERY NPI 1285795567


NPI Information

NPI: 1285795567
Provider Name: PIKES PEAK CENTER FOR COLON & RECTAL SURGERY
Classification: Colon & Rectal Surgery - 208C00000X
Entity Type: Organization

CLIA Number: 06D2184180

Address:
559 EAST PIKES PEAK AVE
SUITE #300
COLORADO SPRINGS, CO
ZIP 80903
Phone: (719) 635-0454
Get Directions

PIKES PEAK CENTER FOR COLON & RECTAL SURGERY is a colon rectal surgery in Colorado Springs, CO. The provider is a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. PIKES PEAK CENTER FOR COLON & RECTAL SURGERY NPI is 1285795567. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

559 EAST PIKES PEAK AVE
SUITE #300
COLORADO SPRINGS, CO
ZIP 80903
Phone: (719) 635-0454
Fax: (719) 473-3476

The provider's authorized official is William G. Rudolph .
The authorized official title is Owner and has the following contact phone number (719) 635-0454.

The CLIA number assigned to this NPI record is 06D2184180 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/12/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208C00000XColon & Rectal Surgery42378COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
168302584MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.