Healthcare Provider Details

I. General information

NPI: 1235012162
Provider Name (Legal Business Name): ALPINE MEDICAL GROUP COLORADO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 PRO RODEO DR
COLORADO SPRINGS CO
80919-2334
US

IV. Provider business mailing address

999 17TH ST STE 500
DENVER CO
80202-2728
US

V. Phone/Fax

Practice location:
  • Phone: 719-632-4455
  • Fax: 360-462-5181
Mailing address:
  • Phone: 719-632-4455
  • Fax: 360-462-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: TRACEY J BAUGHEY
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 267-981-6519