MEDICARE: PREMISE HEALTH OF COLORADO MEDICAL PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1497990287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMISE HEALTH OF COLORADO MEDICAL PC

Provider Business Mailing Address
First Line	:	5500 MARYLAND WAY
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7048
Country	:	US
Telephone Number	:	719-520-7601
Fax Number	:	719-520-7610

Provider Business Practice Location Address
First Line	:	1675 GARDEN OF THE GODS RD
Second Line	:	STE 1053
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-9444
Country	:	US
Telephone Number	:	719-520-7601
Fax Number	:	719-520-7610

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDWARD WILLIAM SCHWARTZ
Credential	:
Telephone Number	:	844-407-7557

Provider Enumeration Date	:	12/08/2008
Last Update Date	:	02/11/2026

Similar Medicare Providers

1477129625 — ANGELA SMOTHERMAN
Practice Location Address:

1675 GARDEN OF THE GODS RD
COLORADO SPRINGS, CO
80907-9444

Practice Phone: 719-339-4129
Practice Fax:

1821078858 — DR. JAMES WAYNE TERBUSH MD
Practice Location Address:

1675 GARDEN OF THE GODS RD , SUITE 2044
COLORADO SPRINGS, CO
80907-9444

Practice Phone: 719-578-3258
Practice Fax: 719-575-8664

1972731008 — ROBIN TRUJILLO RN
Practice Location Address:

1675 GARDEN OF THE GODS RD
COLORADO SPRINGS, CO
80907-9444

Practice Phone: 719-578-3242
Practice Fax: 719-575-8637

1861729394 — MRS. KRISTEN ELLAJANE WATERS R.N.
Practice Location Address:

1675 GARDEN OF THE GODS RD
COLORADO SPRINGS, CO
80907-9444

Practice Phone: 719-578-3242
Practice Fax:

1912278045 — CHRISTINE BURSAW RN
Practice Location Address:

1675 GARDEN OF THE GODS RD , STE 2044
COLORADO SPRINGS, CO
80907-9444

Practice Phone: 719-578-3297
Practice Fax:

1487912622 — MS. MARY CAMILLE KIMBALL R.N., B.S.N.
Practice Location Address:

1675 GARDEN OF THE GODS RD
COLORADO SPRINGS, CO
80907-9444

Practice Phone: 719-578-3218
Practice Fax:

Directions to “PREMISE HEALTH OF COLORADO MEDICAL PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.