Canon Professional Wellness Clinic LLC
NPI 1780384560 · Primary Care Nurse Practitioner · Canon City, CO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Canon Professional Wellness Clinic LLC is a Primary Care Nurse Practitioner organization in Canon City, CO (NPI 1780384560).
Provider details
- NPI number
- 1780384560
- Entity type
- Organization
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Leslie Nelson, Owner(719) 285-5019
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-03-09
- Last updated
- 2024-02-19
- Certified
- 2024-02-19
Frequently asked questions
- What is Canon Professional Wellness Clinic LLC's NPI number?
- Canon Professional Wellness Clinic LLC's National Provider Identifier (NPI) is 1780384560, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Canon Professional Wellness Clinic LLC?
- Canon Professional Wellness Clinic LLC is classified in the NPPES registry as Primary Care Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Canon Professional Wellness Clinic LLC located?
- Canon Professional Wellness Clinic LLC's practice location on file with NPPES is 730 Macon Ave, Canon City, CO 81212-3314.
- What is Canon Professional Wellness Clinic LLC's phone number?
- The practice phone number listed in the NPPES registry for Canon Professional Wellness Clinic LLC is (719) 275-1618.
- Does Canon Professional Wellness Clinic LLC accept Medicare?
- Canon Professional Wellness Clinic LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Canon Professional Wellness Clinic LLC?
- The authorized official listed on Canon Professional Wellness Clinic LLC's NPPES record is Leslie Nelson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Canon Professional Wellness Clinic LLC's NPI active?
- Yes — Canon Professional Wellness Clinic LLC's NPI (1780384560) is active in the NPPES registry as of the last update on 2024-02-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.