Healthcare Provider Details

I. General information

NPI: 1306759626
Provider Name (Legal Business Name): WAYPOINT MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 S TEJON ST STE J
COLORADO SPRINGS CO
80903-2196
US

IV. Provider business mailing address

6050 STETSON HILLS BLVD # 453
COLORADO SPRINGS CO
80923-3562
US

V. Phone/Fax

Practice location:
  • Phone: 719-213-6952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALYCIA LOCKHART
Title or Position: DIRECTOR OF OPERATIONS
Credential: RN
Phone: 719-330-8900