Individual provider Active NPI

Letetia Howard Mobley, NP

  • Family Nurse Practitioner
  • Denver, CO
National Provider Identifier
1215109343
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0990940-NP Issued in CO
Practice address
2130 Stout Street
Denver, CO 80205
Phone
(303) 293-2220
Fax
(303) 293-3977
NPI assigned
Mar 28, 2008
Last updated
Oct 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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.0990940-NP CO Primary

Addresses

Primary practice location

2130 Stout Street
Denver, CO 80205

Mailing address

2111 Champa St
Denver, CO 80205-2529
Phone (303) 293-2220

Other identifiers 1

IdentifierTypeStateIssuer
71125205MedicaidCO

Other names 1

  • Ms. Letetia Paulk Mobley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0990940-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1215109343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 CHAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052529",
            "telephone_number": "303-293-2220",
            "fax_number": "303-293-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 STOUT STREET",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80205",
            "telephone_number": "303-293-2220",
            "fax_number": "303-293-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "LETETIA",
        "middle_name": "HOWARD",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-28",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0990940-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71125205",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETETIA",
            "last_name": "MOBLEY",
            "middle_name": "PAULK",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.