NPIMap

Individual provider Active NPI

Vivian Pacheco

  • Nurse Practitioner
  • Englewood, CO
National Provider Identifier
1225570302
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0992561-NP Issued in CO
Practice address
3425 S Clarkson St
Englewood, CO 80113-2811
Phone
(303) 789-8000
Fax
(303) 789-8442
NPI assigned
Nov 7, 2016
Last updated
Nov 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0992561-NP CO Primary

Addresses

Primary practice location

3425 S Clarkson St
Englewood, CO 80113-2811

Mailing address

3425 S Clarkson St
Englewood, CO 80113-2811
Phone (303) 789-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170424001629 CO Practitioner - Nurse Practitioner 4284910423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Craig HospitalGroup PAC ID 0941119259, 7 clinicians

Practice addresses (Care Compare)

3425 S Clarkson St
Englewood, CO 80113-2811
Phone (303) 789-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN.0992561-NPCOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Craig Hospital CurrentSince Nov 29, 2016 Accepting new patients
Craig Hospital CurrentSince Nov 29, 2016 Accepting new patients

Locations

3425 S Clarkson St
Englewood, CO 80113
Phone (303) 789-8000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 29

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1225570302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 S CLARKSON ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132811",
            "telephone_number": "303-789-8000",
            "fax_number": "303-789-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 S CLARKSON ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132811",
            "telephone_number": "303-789-8000",
            "fax_number": "303-789-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0992561-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.