RIVENDELL HEALTH PC
NPI 1730927567
Clinic/Center - Multi-Specialty in Colorado Springs, CO
About Rivendell Health Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RIVENDELL HEALTH PC (NPI 1730927567) is a healthcare organization registered as a multi-specialty in Colorado Springs, Colorado and active in the NPI registry since July 2024. The organization holds a CLIA Waiver certificate valid through February 25, 2027 and lists Michael R Fry, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Rivendell Health Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Rivendell Health PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Colorado Springs, CO 80920
Colorado Springs, CO 80920
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 06D2319272
Rivendell Health PC · Colorado Springs, COFrequently 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 Rivendell Health PC's NPI number?
The NPI number for Rivendell Health PC is 1730927567. It was assigned to this organization in the NPPES registry on July 16, 2024.
Where is Rivendell Health PC located?
Rivendell Health PC is located at 1465 Kelly Johnson Blvd Ste 310, Colorado Springs, CO 80920. The listed phone number is (719) 726-6573.
What is Rivendell Health PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Rivendell Health PC enrolled in Medicare?
Yes. Rivendell Health PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Rivendell Health PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Rivendell Health PC, in Internal Medicine, Nurse Practitioner and Psychiatry. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Rivendell Health PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 06D2319272) is associated with this NPI, valid through February 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Rivendell Health PC was last updated on July 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Rivendell Health Pc · NPI 1730927567
Multi-Specialty organization in Colorado Springs, Colorado. Organization record, active in the CMS NPPES registry since July 16, 2024.
## Identity
- **NPI:** 1730927567 (Entity type: Organization)
- **Enumerated:** July 16, 2024
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Michael Fry, PRESIDENT
## Practice location
- **Address:** 1465 KELLY JOHNSON BLVD STE 310, Colorado Springs, CO 80920-3947
- **Phone:** (719) 726-6573
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (1), Nurse Practitioner (1), Psychiatry (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 16, 2024
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1730927567) · Data from the CMS NPPES public registry.