Individual provider Active NPI

Jeannie Jo Mueller, PA-C, RD, CDE

  • Physician Assistant
  • Montrose, CO
National Provider Identifier
1083809149
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1010 Rio Grande Ave
Montrose, CO 81401-4831
Phone
(970) 497-3333
Fax
(855) 299-7837
NPI assigned
Sep 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1010 Rio Grande Ave
Montrose, CO 81401-4831

Mailing address

PO Box 529
Olathe, CO 81425-0529
Phone (970) 323-6141

Other practice location 1

308 Main Street
Olathe Comm Clinic DBA River Valley Family Health Ctr
Olathe, CO 81425-0529
Phone (970) 323-6141

Other practice location 2

1250 Valley View Dr
Delta, CO 81416-3138
Phone (970) 874-8981

Other identifiers 2

IdentifierTypeStateIssuer
18408745MedicaidCO
P01316438OtherRAILROAD WORKERS MEDICARE / OLATHE COMM CLINIC DBA RIVER VALLEY FAMILY HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100617000622 CO Practitioner - Physician Assistant 3678603628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olathe Community Clinic IncGroup PAC ID 5395998744, 23 clinicians

Practice addresses (Care Compare)

1010 S Rio Grande Ave
Montrose, CO 81401-4831
Phone (970) 497-3333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0002513COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Olathe Community Clinic Inc Family Medicine CurrentSince Apr 24, 2013 Accepting new patients
Olathe Community Clinic Inc Past Accepting new patients

Locations

1250 Valley View Dr
Delta, CO 81416
Phone (970) 874-8981

1010 S Rio Grande Ave
Montrose, CO 81401
Phone (970) 497-3333

Interoperability endpoints

  • Direct secure messaging: jeannie.mueller.1@19850.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1083809149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 529",
            "city": "OLATHE",
            "state": "CO",
            "postal_code": "814250529",
            "telephone_number": "970-323-6141",
            "fax_number": "970-323-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 RIO GRANDE AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814014831",
            "telephone_number": "970-497-3333",
            "fax_number": "855-299-7837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Main Street",
            "address_2": "Olathe Comm Clinic DBA River Valley Family Health Ctr",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "CO",
            "postal_code": "814250529",
            "country_code": "US",
            "telephone_number": "970-323-6141",
            "fax_number": "970-323-6117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 Valley View Dr",
            "address_purpose": "LOCATION",
            "city": "Delta",
            "state": "CO",
            "postal_code": "814163138",
            "country_code": "US",
            "telephone_number": "970-874-8981",
            "fax_number": "855-299-7586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "JEANNIE",
        "middle_name": "JO",
        "credential": "PA-C, RD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18408745",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD WORKERS MEDICARE / OLATHE COMM CLINIC DBA RIVER VALLEY FAMILY HEALTH",
            "identifier": "P01316438",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

Verify at the official NPI Registry.