Brandy Knudtson
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Johnstown, CO
NPI 1194124420 · NPPES record last updated Jun 5, 2024
Key facts
- NPI
- 1194124420
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APN.0998741-NP (CO)
- Practice address
- PO Box 854
Johnstown, CO 80534-0854 - Phone
- (970) 578-9010
- Fax
- (970) 578-9027
- NPI assigned
- Aug 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231110002611 | CO | Practitioner - Nurse Practitioner | 0547617649 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0200392 | CO | MD | Registered Nurse |
| APN.0998741-NP | CO | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Center, LLC | Current |
Accepting new patients | |
| Family Care Center, LLC | Psychiatry | Current |
Accepting new patients |
| Sondermind Provider Network LLC | Psychiatry | Current |
Accepting new patients |
| National Mental Health Management, LLC | Past |
Accepting new patients |
Locations
2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002
720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0200392 | CO | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APN.0998741-NP | CO | Yes |
Addresses
Primary practice location
PO Box 854
Johnstown, CO 80534-0854
Mailing address
PO Box 854
Johnstown, CO 80534-0854
Phone (970) 578-9010
Other providers in Johnstown, CO
- Johnstown Heights Behavioral Health, LLC
- Johnstown Pediatric Dentistry PLLC
- Kaiser Foundation Health Plan of Co
- Kaiser Foundation Health Plan of Colorado
- Thomas A Kenigsberg
- Christopher J Kottenstette
- Joseph Thomas Kraus
- Eric Jonathan Krinsky
- Matthew Krizek
- Molly A Lalonde
All providers in Johnstown, CO · Psychiatric/Mental Health Nurse Practitioner in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.