Individual provider Active NPI

Joan Irene Primozich, FNPC

  • Nurse Practitioner
  • Aurora, CO
National Provider Identifier
1033232541
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10073 Issued in CO
Practice address
1400 S Potomac St Ste 190
Aurora, CO 80012-4514
Phone
(209) 790-8367
Fax
(303) 369-1919
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP2010 AZ
Nurse Practitioner 363L00000X 10073 CO Primary

Addresses

Primary practice location

1400 S Potomac St Ste 190
Aurora, CO 80012-4514

Mailing address

4900 S Monaco St
#210
Denver, CO 80237-3486
Phone (303) 226-6180

Other identifiers 2

IdentifierTypeStateIssuer
200750460AMedicaidKS
55832873MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10073COMDPhysical Therapist
AP2010AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Chiropractic & Wellness, L.L.C PastSince Jun 29, 2020 Accepting new patients

Organizations & group practices 1

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1033232541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST",
            "address_2": "#210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373486",
            "telephone_number": "303-226-6180",
            "fax_number": "720-870-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S POTOMAC ST STE 190",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124514",
            "telephone_number": "209-790-8367",
            "fax_number": "303-369-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMOZICH",
        "first_name": "JOAN",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP2010",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "10073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200750460A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55832873",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.