Individual provider Active NPI

Lora Shima, FNP-C

  • Family Nurse Practitioner
  • Broomfield, CO
National Provider Identifier
1154046753
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0997924-NP Issued in CO
Practice address
12167 Sheridan Blvd
Broomfield, CO 80020-2417
Phone
(303) 658-9807
NPI assigned
Oct 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0997924-NP CO Primary

Addresses

Primary practice location

12167 Sheridan Blvd
Broomfield, CO 80020-2417

Mailing address

2620 Elm Hill Pike
Nashville, TN 37214-3108

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
I20221019001346 CO Practitioner - Nurse Practitioner 3577939347 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0997924-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Colorado, LLC Family CurrentSince Nov 1, 2022 Accepting new patients
University of Colorado Past Accepting new patients

Locations

12167 Sheridan Blvd
Broomfield, CO 80020
Phone (303) 439-0169

2355 W 136th Ave
Broomfield, CO 80023
Phone (303) 658-9827

7984 W Alameda Ave
Lakewood, CO 80226
Phone (303) 459-7105

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

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": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1154046753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12167 SHERIDAN BLVD",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202417",
            "telephone_number": "303-658-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMA",
        "first_name": "LORA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0997924-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.