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Individual provider Active NPI

Jodie Kay Mesa, DO

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1114187648
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR-54111 Issued in CO
Practice address
8540 Scarborough Dr
Suite 100
Colorado Springs, CO 80920-7502
Phone
(719) 955-4200
Fax
(719) 365-7667
NPI assigned
Jun 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R-9579 IA
Family Medicine Physician 207Q00000X DR-54111 CO Primary

Addresses

Primary practice location

8540 Scarborough Dr
Suite 100
Colorado Springs, CO 80920-7502

Mailing address

8540 Scarborough Dr
Suite 100
Colorado Springs, CO 80920-7502
Phone (719) 955-4200

Other identifiers 1

IdentifierTypeStateIssuer
58052348MedicaidCO

Other names 1

  • Dr. Jodie Kay Hamer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908002465 CO Practitioner - Family Practice 6507085438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1700 N Marion St
Denver, CO 80218-1121
Phone (303) 860-7770

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Uchealth Grandview Hospital Hospital, Colorado Springs, CO, CCN 060130

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DR-54111COMDFamily Medicine Physician
R-9579IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 21, 2014 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 21, 2014 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

8540 Scarborough Dr
Ste 100
Colorado Springs, CO 80920
Phone (719) 364-6970

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1114187648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 SCARBOROUGH DR",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207502",
            "telephone_number": "719-955-4200",
            "fax_number": "719-365-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 SCARBOROUGH DR",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207502",
            "telephone_number": "719-955-4200",
            "fax_number": "719-365-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESA",
        "first_name": "JODIE",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-9579",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR-54111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58052348",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODIE",
            "last_name": "HAMER",
            "middle_name": "KAY",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.