Individual provider Active NPI

Jill Nicole Chisolm, F.N.P

  • Family Nurse Practitioner
  • Denver, CO
National Provider Identifier
1184020919
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0991298 Issued in CO
Practice address
3447 Humboldt St
Denver, CO 80205-3937
Phone
(303) 518-6566
NPI assigned
Nov 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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 0991298 CO Primary

Addresses

Primary practice location

3447 Humboldt St
Denver, CO 80205-3937

Mailing address

3447 Humboldt St
Denver, CO 80205-3937
Phone (303) 518-6566

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jchisolm70916@direct.dhha.org Health Information Exchange (HIE)

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
I20161108002353 CO Practitioner - Nurse Practitioner 1456630839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

Merit-based Incentive Payment System (MIPS)

Final score
96.65 of 100Reported as group
Quality
92.15
Promoting interoperability
100
Improvement activities
40
Cost
80.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0991298COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Aug 29, 2016 Accepting new patients
Denver Health and Hospital Authority CurrentSince Aug 29, 2016 Accepting new patients

Locations

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: jchisolm70916@direct.dhha.org

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": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1184020919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3447 HUMBOLDT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053937",
            "telephone_number": "303-518-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3447 HUMBOLDT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053937",
            "telephone_number": "303-518-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISOLM",
        "first_name": "JILL",
        "middle_name": "NICOLE",
        "credential": "F.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0991298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchisolm70916@direct.dhha.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bannock St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802044507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.