Active NPI
Jennifer Mahoney, CPNP
- Pediatric Nurse Practitioner
- Centennial, CO
National Provider Identifier
1215078852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 100857
- Practice address
- 9094 E Mineral Cir
Suite 100
Centennial, CO 80112-7200 - Phone
- (303) 694-3200
- Fax
- (303) 694-2680
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 100857 | CO | Primary |
Addresses
Primary practice location
9094 E Mineral Cir
Suite 100
Centennial, CO 80112-7200
Mailing address
9094 E Mineral Cir
Suite 100
Centennial, CO 80112-7200
Phone (303) 694-3200
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
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100857 | CO | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenwood Pediatrics PC | Past | 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.
-
- Primary Care Clinic/Center
- Centennial, CO
- NPI 1619013448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215078852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9094 E MINERAL CIR",
"address_2": "SUITE 100",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801127200",
"telephone_number": "303-694-3200",
"fax_number": "303-694-2680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9094 E MINERAL CIR",
"address_2": "SUITE 100",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801127200",
"telephone_number": "303-694-3200",
"fax_number": "303-694-2680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "JENNIFER",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CO",
"license": "100857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.