Healthcare Provider Details

I. General information

NPI: 1346273521
Provider Name (Legal Business Name): PIKES PEAK ALLERGY & ASTHMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 CHAPEL HILLS DR 102
COLORADO SPRINGS CO
80920-1024
US

IV. Provider business mailing address

1710 JET STREAM DR STE 105
COLORADO SPRINGS CO
80921-3937
US

V. Phone/Fax

Practice location:
  • Phone: 719-578-0909
  • Fax: 719-260-7790
Mailing address:
  • Phone: 719-260-1022
  • Fax: 719-260-7790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHANAEL STEVEN BRADY
Title or Position: OWNER / PHYSICIAN
Credential: D.O.
Phone: 719-260-1022