Individual provider Active NPI

Jessica Perz Wulfekuhler, NP

  • Pediatric Nurse Practitioner
  • Denver, CO
National Provider Identifier
1104128537
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN.0994994-NP Issued in CO
Practice address
2055 N High St Ste 110
Denver, CO 80205-5504
Phone
(303) 301-9019
Fax
(303) 861-6254
NPI assigned
Nov 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN.0994994-NP CO Primary

Addresses

Primary practice location

2055 N High St Ste 110
Denver, CO 80205-5504

Mailing address

2055 N High St Ste 110
Denver, CO 80205-5504
Phone (303) 301-9019

Other identifiers 1

IdentifierTypeStateIssuer
9000179925MedicaidCO

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
I20240606002878 CO Practitioner - Nurse Practitioner 5799227682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0994994-NPCOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthone Clinic Services - Pediatric Specialties LLC CurrentSince Jun 10, 2024 Accepting new patients
Jefferson County Colorado Past Accepting new patients

Locations

2055 N High St
Ste 370
Denver, CO 80205

2055 N High St
Ste 110
Denver, CO 80205
Phone (303) 301-9019

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: jessica.wulfekuhler@hca3.eclinicaldirectplus.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.

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1104128537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 N HIGH ST STE 110",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055504",
            "telephone_number": "303-301-9019",
            "fax_number": "303-861-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N HIGH ST STE 110",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055504",
            "telephone_number": "303-301-9019",
            "fax_number": "303-861-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WULFEKUHLER",
        "first_name": "JESSICA",
        "middle_name": "PERZ",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0994994-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000179925",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.