Individual provider Active NPI

Jennifer L Loucks, M.D.

  • Rheumatology Physician
  • Englewood, CO
National Provider Identifier
1023040011
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
41330 Issued in CO
Practice address
701 E Hampden Ave
Ste 410
Englewood, CO 80113-2736
Phone
(303) 788-1312
Fax
(303) 788-1967
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 41330 CO Primary

Addresses

Primary practice location

701 E Hampden Ave
Ste 410
Englewood, CO 80113-2736

Mailing address

701 E Hampden Ave
Ste 410
Englewood, CO 80113-2736
Phone (303) 788-1312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060809000002 CO Practitioner - Rheumatology 4981607116 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41330COMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Nov 15, 2007 Accepting new patients
Denver Health and Hospital Authority CurrentSince Nov 15, 2007 Accepting new patients

Locations

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1023040011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E HAMPDEN AVE",
            "address_2": "STE 410",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132736",
            "telephone_number": "303-788-1312",
            "fax_number": "303-788-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E HAMPDEN AVE",
            "address_2": "STE 410",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132736",
            "telephone_number": "303-788-1312",
            "fax_number": "303-788-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUCKS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CO",
            "license": "41330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.