Individual provider Active NPI

Jaimee R Pacheco, PA-C

  • Medical Physician Assistant
  • Greenwood Village, CO
National Provider Identifier
1053355263
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1799 Issued in CO
Practice address
7400 E Crestline Cir
Suite 100
Greenwood Village, CO 80111-3652
Phone
(303) 792-3242
Fax
(303) 792-9403
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1799 CO Primary
Surgical Physician Assistant 363AS0400X 1799 CO

Addresses

Primary practice location

7400 E Crestline Cir
Suite 100
Greenwood Village, CO 80111-3652

Mailing address

7400 E Crestline Cir
Suite 100
Greenwood Village, CO 80111-3652
Phone (303) 792-3242

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1799COMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1053355263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 E CRESTLINE CIR",
            "address_2": "SUITE 100",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113652",
            "telephone_number": "303-792-3242",
            "fax_number": "303-792-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 E CRESTLINE CIR",
            "address_2": "SUITE 100",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113652",
            "telephone_number": "303-792-3242",
            "fax_number": "303-792-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "JAIMEE",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1799",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "1799",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; 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.