Healthcare Provider Details

I. General information

NPI: 1306269261
Provider Name (Legal Business Name): FRONT RANGE URGENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6908 MESA RIDGE PKWY
FOUNTAIN CO
80817-1533
US

IV. Provider business mailing address

5799 STETSON HILLS BLVD
COLORADO SPRINGS CO
80917-4223
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-2273
  • Fax: 719-380-0228
Mailing address:
  • Phone: 719-471-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number49109
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number49109
License Number StateCO

VIII. Authorized Official

Name: ANITA WIESCAMP
Title or Position: OWNER
Credential:
Phone: 719-510-0957