1. Home
  2. Directory
  3. Colorado
  4. Springs
  5. Physician Assistant
  6. NPI Profile

LAURIE MARGUERITE MEDIAVILLA P.A.-C
NPI 1568513000
Physician Assistant in Colorado Springs, CO

Active since January 12, 2007
825 E PIKES PEAK AVE, COLORADO SPRINGS, CO 80903(719) 776-8850(719) 776-8854 Get Directions Write a Review

NPPES record last updated: December 16, 2019. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Laurie Marguerite Mediavilla P.a.-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAURIE MARGUERITE MEDIAVILLA P.A.-C (NPI 1568513000) is an individual physician assistant in Colorado Springs, Colorado, licensed in Colorado (PA.0001028) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1568513000
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameLAURIE MARGUERITE MEDIAVILLACredential: P.A.-C
Location Address825 E PIKES PEAK AVEColorado Springs, CO 80903-3624
Mailing Address825 E Pikes Peak AveColorado Springs, CO 80903-3624 · (719) 776-8850 · Fax (719) 776-8854
Phone(719) 776-8850
Fax(719) 776-8854
Sole ProprietorNo
Enumeration DateJanuary 12, 2007
Last NPPES UpdateDecember 16, 2019
✔ NPI 1568513000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CO · PA.0001028
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 1028 (CO)
825 E PIKES PEAK AVE, Colorado Springs, CO 80903
Open in Google Maps ↗

Other Identifiers 1

Medicaid71906240CO

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUSAN M KWIECIEN
Marriage & Family Therapist
825 E PIKES PEAK AVE
COLORADO SPRINGS, CO 80903
El Paso County (719) 776-8325
KAY J MCCARTHY RNC, LMFT
Registered Nurse (Psychiatric/Mental Health)
825 E PIKES PEAK AVE, BEHAVIORAL HEALTH DEPT
COLORADO SPRINGS, CO 80903
El Paso County (719) 776-8481
JAMES DALE SAUNDERS LPC, LAC, MAC
Counselor (Addiction (Substance Use Disorder))
825 E PIKES PEAK AVE
COLORADO SPRINGS, CO 80903
El Paso County (719) 776-8487
MS. DARLENE GRIPPO - SOWA LPC
Counselor (Professional)
825 E PIKES PEAK AVE, BEHAVIORAL HEALTH DEPT.
COLORADO SPRINGS, CO 80903
El Paso County (719) 776-8482
CATHOLIC HEALTH INIATIVES COLORADO
Psychiatry & Neurology (Psychiatry)
825 E PIKES PEAK AVE
COLORADO SPRINGS, CO 80903
El Paso County (719) 776-8325
CATHOLIC HEALTH INITIATIVES COLORADO
General Acute Care Hospital
825 E PIKES PEAK AVE, CENTER FOR BEHAVIORAL HEALTH
COLORADO SPRINGS, CO 80903
El Paso County (719) 776-8335
CHARLENE B COFFIN
Counselor (Professional)
825 E PIKES PEAK AVE
COLORADO SPRINGS, CO 80903
El Paso County (719) 776-8325
ANNA BROU M.D.
Family Medicine
825 E PIKES PEAK AVE, SUITE 109
COLORADO SPRINGS, CO 80903
El Paso County (719) 577-9977

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Laurie Mediavilla's NPI number?

The NPI number for Laurie Mediavilla is 1568513000. It was assigned to this individual provider in the NPPES registry on January 12, 2007.

Where is Laurie Mediavilla located?

Laurie Mediavilla practices at 825 E Pikes Peak Ave, Colorado Springs, CO 80903. The listed phone number is (719) 776-8850.

What is Laurie Mediavilla's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Laurie Mediavilla was last updated on December 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.