Individual provider Active NPI

Jacqueline Magdalena Hooper, NP

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1225323405
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0990078-NP Issued in CO
Practice address
2610 Tenderfoot Hill St
Colorado Springs, CO 80906
Phone
(719) 522-1133
Fax
(719) 576-2025
NPI assigned
Jun 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP990078 CO
Family Nurse Practitioner 363LF0000X CNP01768 NM
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X APN.0990078-NP CO Primary

Addresses

Primary practice location

2610 Tenderfoot Hill St
Colorado Springs, CO 80906

Mailing address

2 S Cascade Ave Ste 140
Colorado Springs, CO 80903-1604
Phone (719) 866-6568

Other identifiers 2

IdentifierTypeStateIssuer
APN.0990078-NPOtherCOCO MEDICAL LICENSE
3560545MedicaidCO

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
I20130923000476 CO Practitioner - Nurse Practitioner 9931343456 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0990078-NPCOMDFamily Nurse Practitioner
NP990078COMDFamily Nurse Practitioner
CNP01768NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Colorado Medical Group LLC CurrentSince Apr 6, 2018 Accepting new patients
Optumcare Colorado Medical Group LLC Multi-Specialty CurrentSince Apr 6, 2018 Accepting new patients

Locations

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

2610 Tenderfoot Hill St
Colorado Springs, CO 80906
Phone (719) 576-3901

1625 Medical Center Pt
Ste 200
Colorado Springs, CO 80907
Phone (719) 630-3276

2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900

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": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1225323405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S CASCADE AVE STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031604",
            "telephone_number": "719-866-6568",
            "fax_number": "719-538-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 TENDERFOOT HILL ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80906",
            "telephone_number": "719-522-1133",
            "fax_number": "719-576-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOPER",
        "first_name": "JACQUELINE",
        "middle_name": "MAGDALENA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "NP990078",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP01768",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0990078-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO MEDICAL LICENSE",
            "identifier": "APN.0990078-NP",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3560545",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.