Rachel Bletzacker, FNP-BC
Individual provider Active NPI Nurse Practitioner · Eads, CO
NPI 1013645845 · NPPES record last updated Jun 27, 2024
Key facts
- NPI
- 1013645845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 0997758 (CO)
- Practice address
- 1208 Luther St
Eads, CO 81036-0817 - Phone
- (719) 438-2251
- Fax
- (719) 438-2254
- NPI assigned
- Aug 10, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- County of Kiowa Hospital District
Practice addresses (Care Compare)
PO Box
Suite 817
Eads, CO 81036
Hospital & facility affiliations
- Weisbrod Memorial County Hospital
- Prowers Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221010001108 | CO | Practitioner - Nurse Practitioner | 2961888268 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0997758 | CO | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Kiowa Hospital District | Current |
Accepting new patients | |
| County of Kiowa Hospital District | Current |
Accepting new patients | |
| County of Kiowa Hospital District | Past | Accepting new patients | |
| County of Kiowa Hospital District | Past | Accepting new patients |
Interoperability endpoints
- rachel.bletzacker.1@17361.direct.athenahealth.com
- https://api.platform.athenahealth.com/17361/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0997758 | CO | Yes |
Addresses
Primary practice location
1208 Luther St
Eads, CO 81036-0817
Mailing address
PO Box 817
Eads, CO 81036-0817
Phone (719) 438-5401
Other providers in Eads, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.