Individual provider Active NPI

Tamara Anne Bockman, PMHNP

  • Psychiatric/Mental Health Registered Nurse
  • Niwot, CO
National Provider Identifier
1225633480
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
APN.0996095-NP Issued in CO
Practice address
6897 Paiute Ave Ste 5
Niwot, CO 80503-7169
Phone
(303) 652-4196
NPI assigned
Dec 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X APN.0996095-NP CO Primary

Addresses

Primary practice location

6897 Paiute Ave Ste 5
Niwot, CO 80503-7169

Mailing address

6897 Paiute Ave Ste 5
Niwot, CO 80503-7169
Phone (303) 652-4196

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
I20210219000298 CO Practitioner - Nurse Practitioner 4183039498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amavi Integrative Mental Wellness LLCGroup PAC ID 4082043401, 27 clinicians

Practice addresses (Care Compare)

6897 Paiute Ave
Suite 5
Niwot, CO 80503-7169
Phone (303) 652-4196

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0996095-NPCOMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Amavi Integrative Mental Wellness LLC Psychiatric/Mental Health CurrentSince Feb 1, 2021 Accepting new patients

Locations

6897 Paiute Ave
Ste 5
Niwot, CO 80503
Phone (303) 652-4196

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1225633480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6897 PAIUTE AVE STE 5",
            "city": "NIWOT",
            "state": "CO",
            "postal_code": "805037169",
            "telephone_number": "303-652-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6897 PAIUTE AVE STE 5",
            "city": "NIWOT",
            "state": "CO",
            "postal_code": "805037169",
            "telephone_number": "303-652-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKMAN",
        "first_name": "TAMARA",
        "middle_name": "ANNE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0996095-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niwot, CO

Sources for this page

Verify at the official NPI Registry.