Individual provider Active NPI

Jared Johnson, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Brighton, CO
National Provider Identifier
1124736418
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APN.0998160-NP Issued in CO
Practice address
1600 Prairie Center Pkwy
Brighton, CO 80601-4006
Phone
(303) 498-1910
NPI assigned
Nov 7, 2022
Last updated
Nov 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APN.0998160-NP CO Primary

Addresses

Primary practice location

1600 Prairie Center Pkwy
Brighton, CO 80601-4006

Mailing address

13719 Vallejo Loop
Broomfield, CO 80023-7422
Phone (720) 347-5231

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
I20230213001752 CO Practitioner - Nurse Practitioner 7315319720 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Colorado-Professional, LLC Current Accepting new patients
Healogics Specialty Physicians of Colorado-Professional, LLC CurrentSince May 1, 2023 Accepting new patients
Brighton Community Emergency Physicians Lpa Emergency Medicine CurrentSince Nov 8, 2022 Accepting new patients

Locations

9399 Crown Crest Blvd
Ste 430
Parker, CO 80138
Phone (303) 269-2310

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1124736418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13719 VALLEJO LOOP",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800237422",
            "telephone_number": "720-347-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PRAIRIE CENTER PKWY",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014006",
            "telephone_number": "303-498-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JARED",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "APN.0998160-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

Verify at the official NPI Registry.