Individual provider Active NPI

Jane Moore Duncan, FNP C

  • Family Nurse Practitioner
  • Greeley, CO
National Provider Identifier
1063401396
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0003436 Issued in CO
Practice address
1675 18TH Ave
Suite 3
Greeley, CO 80631-5112
Phone
(970) 347-5780
Fax
(970) 347-5799
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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.0102634 CO
Nurse Practitioner 363L00000X APN.0003436 CO
Family Nurse Practitioner 363LF0000X APN.0003436 CO Primary

Addresses

Primary practice location

1675 18TH Ave
Suite 3
Greeley, CO 80631-5112

Mailing address

1675 18TH Ave
Suite 3
Greeley, CO 80631-5112
Phone (970) 347-5780

Other identifiers 2

IdentifierTypeStateIssuer
21751749MedicaidCO
P01231653OtherCOMEDICARE RAILROAD

Other names 1

  • Mitzi Duncan Other name

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
RN.0102634COMDRegistered Nurse
APN.0003436COMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1063401396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 18TH AVE",
            "address_2": "SUITE 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315112",
            "telephone_number": "970-347-5780",
            "fax_number": "970-347-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 18TH AVE",
            "address_2": "SUITE 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315112",
            "telephone_number": "970-347-5780",
            "fax_number": "970-347-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "JANE",
        "middle_name": "MOORE",
        "name_prefix": "Ms.",
        "credential": "FNP C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0102634",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0003436",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0003436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21751749",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01231653",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MITZI",
            "last_name": "DUNCAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.