Nicole Buccelli

Key facts

NPI

1134849201

Entity type

Individual (NPI type 1)

Primary specialty

Community Health Worker 172V00000X

Practice address

928 12TH St
Greeley, CO 80631-4024

Phone

(970) 347-2120

NPI assigned

Aug 30, 2022

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 30, 2022.

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1134849201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319584",
            "telephone_number": "212-097-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 12TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806314024",
            "telephone_number": "970-347-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCELLI",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

• Rachael M Brunkow, PEER
• Ann Brunner
• Jovanna Brunner
• Daniel L Bruns, PSYD
• Cara R Bruntz, NP
• Teresa Bucenec
• Caitlin Emily Buchholz
• Breanna Buchman, DMD
• Amber Buck, D.C.
• McKinna Buck

All providers in Greeley, CO · Community Health Worker in Colorado