Healthcare Provider Details

I. General information

NPI: 1679496178
Provider Name (Legal Business Name): ALTITUDE SURGICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2955 PROFESSIONAL PL STE 100
COLORADO SPRINGS CO
80904-8140
US

IV. Provider business mailing address

2955 PROFESSIONAL PL STE 100
COLORADO SPRINGS CO
80904-8140
US

V. Phone/Fax

Practice location:
  • Phone: 979-204-6807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW WHINERY
Title or Position: PHYSICIAN
Credential: MD
Phone: 979-204-6807