Jennifer E. Deraad, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APN0995434 Issued in CO

Practice address

1136 E Stuart St Ste 202
Fort Collins, CO 80525-1195

Phone

(970) 829-1129

NPI assigned

Sep 1, 2011

Last updated

Jul 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bewellness, LLC

  • Family Nurse Practitioner
  • Fort Collins, CO
  • NPI 1356137905
  NPD

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1063793289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 E STUART ST STE 202",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251195",
            "telephone_number": "970-829-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 E STUART ST STE 202",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251195",
            "telephone_number": "970-829-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAAD",
        "first_name": "JENNIFER",
        "middle_name": "E.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "12614-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN0995434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BEWELLMENTALHEALTH.COM",
            "affiliation": "N",
            "endpointDescription": "OFFICE",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fort Collins",
            "address_1": "1136 E Stuart St Ste 202",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805251195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abigail Depperschmidt, PT
• Craig D Depperschmidt, PT, DPT
• Depression & Bipolar Clinic of Colorado, PLLC.
• Kirk Lee Depriest, DO
• Kellie Dequasie, RN
• Sandra Marie Deraney Reilly, PHD
• Michael A. Deringer, M.D.
• Peggy Ann Derloshon, DDS
• Dermatology & Laser Center of Fort Collins LLC
• Dermatology of Northern Colorado P.C.

• Psychiatric/Mental Health Nurse Practitioner in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.