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RIVENDELL HEALTH PC
NPI 1730927567
Clinic/Center - Multi-Specialty in Colorado Springs, CO

Active since July 16, 2024CLIA 06D2319272 · Waiver
1465 KELLY JOHNSON BLVD STE 310, COLORADO SPRINGS, CO 80920(719) 726-6573 Get Directions Write a Review

NPPES record last updated: July 16, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

NPI1730927567
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameRIVENDELL HEALTH PC
Location Address1465 KELLY JOHNSON BLVD STE 310Colorado Springs, CO 80920-3947
Mailing Address1465 Kelly Johnson Blvd Ste 310Colorado Springs, CO 80920-3947 · (719) 726-6573
Phone(719) 726-6573
Organization SubpartNo
Authorized OfficialMichael R FryPresident · (719) 726-6573
Enumeration DateJuly 16, 2024
NPPES CertifiedJuly 16, 2024
✔ NPI 1730927567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
1465 KELLY JOHNSON BLVD STE 310, Colorado Springs, CO 80920
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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, CO
Active · expires Feb 25, 2027
CLIA Number06D2319272
Laboratory TypePhysician Office
Certificate Effective DateFebruary 26, 2025
Certificate Expiration DateFebruary 25, 2027
Laboratory DirectorMichael R. Fry
Laboratory Phone(719) 726-6573
Laboratory LocationRivendell Health PC1465 Kelly Johnson Blvd, #310, Colorado Springs, CO 80920
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

MRS. BRITTANY ANN OMER FNP-C
Nurse Practitioner (Family)
1465 KELLY JOHNSON BLVD STE 310
COLORADO SPRINGS, CO 80920
El Paso County (719) 726-6573
MADELEINE NELSON
Physician Assistant
1465 KELLY JOHNSON BLVD STE 310
COLORADO SPRINGS, CO 80920
El Paso County (719) 726-6573
DR. MICHAEL REED FRY DO
Hospitalist
1465 KELLY JOHNSON BLVD STE 310
COLORADO SPRINGS, CO 80920
El Paso County (360) 689-6462

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 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.

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.