MEDICARE: CATHOLIC HEALTH INITIATIVES COLORADO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1508475278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC HEALTH INITIATIVES COLORADO

Provider Business Mailing Address
First Line	:	PO BOX 800022
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64180-0022
Country	:	US
Telephone Number	:	800-953-0104
Fax Number	:	303-765-6670

Provider Business Practice Location Address
First Line	:	1263 LAKE PLAZA DR STE 210A
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3564
Country	:	US
Telephone Number	:	719-776-3360
Fax Number	:	719-776-3374

Authorized Official
Title or Position	:	ADMINISTRATOR, OMA
Name	:	MRS. ANGELA J SKINNER
Credential	:
Telephone Number	:	303-673-7175

Provider Enumeration Date	:	07/28/2020
Last Update Date	:	09/10/2020

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