Individual provider Active NPI

Samantha Mary Gimelli Lange, FNP-C

  • Pediatric Nurse Practitioner
  • Aurora, CO
National Provider Identifier
1023781523
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN.0996681-NP Issued in CO
Practice address
1775 Aurora CT RM 2404
Aurora, CO 80045-2536
Phone
(303) 724-7514
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.1628476 CO
Family Nurse Practitioner 363LF0000X APN.0996681-NP CO
Pediatric Nurse Practitioner 363LP0200X APN.0996681-NP CO Primary

Addresses

Primary practice location

1775 Aurora CT RM 2404
Aurora, CO 80045-2536

Mailing address

26229 E Maple Dr
Aurora, CO 80018-4671
Phone (720) 939-0605

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220114001632 CO Practitioner - Nurse Practitioner 9638561038 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.1628476COMDRegistered Nurse
APN.0996681-NPCOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated CurrentSince Dec 15, 2021 Accepting new patients
University Physicians Incorporated Nurse Practitioner Current Accepting new patients
University Physicians, Incorporated CurrentSince Dec 15, 2021 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
University Physicians, Incorporated Past Accepting new patients

Locations

1775 Aurora Ct
Rm 2404
Aurora, CO 80045
Phone (303) 724-7514

1775 Aurora Ct
Ste A140
Aurora, CO 80045
Phone (303) 724-2323

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

Interoperability endpoints

  • Direct secure messaging: slange92836@direct.childrenscolorado.org

Organizations & group practices 5

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": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1023781523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26229 E MAPLE DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800184671",
            "telephone_number": "720-939-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 AURORA CT RM 2404",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452536",
            "telephone_number": "303-724-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "SAMANTHA",
        "middle_name": "MARY GIMELLI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.1628476",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0996681-NP",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0996681-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.