Jacqueline C. Fields, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

33698 Issued in CO

Practice address

315 Canyon Ave
Suite 1
Fort Collins, CO 80521-2677

Phone

(970) 472-6789

Fax

(970) 472-6799

NPI assigned

Aug 22, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 13, 2017 through Dec 13, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Healing Gardens Health Center

  • Family Medicine Physician
  • Fort Collins, CO
  • NPI 1376602581
  NPD (past) Authorized official
• Innerhealth LLC

  • Multi-Specialty Clinic/Center
  • Fort Collins, CO
  • NPI 1053390336
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1043202385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 CANYON AVE",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805212677",
            "telephone_number": "970-472-6789",
            "fax_number": "970-472-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 CANYON AVE",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805212677",
            "telephone_number": "970-472-6789",
            "fax_number": "970-472-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "JACQUELINE",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "33698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01336981",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Ferrer
• Rebecca Ferrera, RMT
• Ryan Fey, LMT
• Nicholas Ficek, IOMT
• Jennifer Fieldhack
• Jason D Fife, MD
• Figure It Out Counseling, LLC
• Piotr Jacek Filipowski, M.D.
• Derek Ryan Filkins, MS, LPC
• Jamie L Fillmore, D.M.D.

• Specialist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.