Individual provider Active NPI

Jessica Neilson, RMA

  • Laboratory Management Specialist/Technologist
  • Colorado Springs, CO
National Provider Identifier
1184317976
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Laboratory Management Specialist/TechnologistTaxonomy code 246QL0900X
License
06D2281283 Issued in CO
Practice address
1732 Summernight Ter
Colorado Springs, CO 80909-2728
Phone
(608) 799-5651
NPI assigned
May 30, 2023
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Laboratory Management Specialist/Technologist 246QL0900X 06D2281283 CO Primary

Addresses

Primary practice location

1732 Summernight Ter
Colorado Springs, CO 80909-2728

Mailing address

1732 Summernight Ter
Colorado Springs, CO 80909-2728
Phone (608) 799-5651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Medical Assistant

State licenses

LicenseStateTypeSpecialty
06D2281283COMDLaboratory Management Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stat Mobile Labs, LLC CurrentSince Jul 2, 2023 Accepting new patients

Organizations & group practices 1

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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1184317976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 SUMMERNIGHT TER",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809092728",
            "telephone_number": "608-799-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 SUMMERNIGHT TER",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809092728",
            "telephone_number": "608-799-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSON",
        "first_name": "JESSICA",
        "credential": "RMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QL0900X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management",
            "state": "CO",
            "license": "06D2281283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.