Organization
THE LITTLE CLINIC OF COLORADO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS SHELLY (VP & GENERAL MANAGER)
(615) 425-4200
Entity
Organization
Contact information
Practice address
3620 AUSTIN BLUFFS PKWY, COLORADO SPRINGS, CO 80918-6631
(719) 325-0342
(719) 325-0343
Mailing address
PO BOX 932958, CLEVELAND, OH 44193-0028
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000165174
—
CO
Enumeration date
10/05/2020
Last updated
10/22/2025
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