Jodie Lynn Gallegos, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

993624 Issued in CO

Practice address

2773 Janitell Rd
Colorado Springs, CO 80906-4102

Phone

(719) 365-6478

NPI assigned

Apr 13, 2018

Reactivated

May 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group NPD
• Immersiv Health of Colorado, PLLC

  • Infectious Disease Physician
  • Greeley, CO
  • NPI 1043043466
  Medicare reassignment NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Immersiv Health of Colorado, PLLC

  • Infectious Disease Physician
  • Fort Collins, CO
  • NPI 1831914993
  NPD (past)

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1235626466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2773 JANITELL RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064102",
            "telephone_number": "719-365-6478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4323 Integrity Center Pt",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809171683",
            "country_code": "US",
            "telephone_number": "719-591-2558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13445 Voyager Pkwy",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809217648",
            "country_code": "US",
            "telephone_number": "719-365-3220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1035 Garden Of The Gods Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809073416",
            "country_code": "US",
            "telephone_number": "719-365-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "JODIE",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "deactivation_date": "2021-03-31",
        "reactivation_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "993624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amberly Gallagher, MS/MFTC
• Lacee Lea Gallagher, PHARM.D.
• Dylan Gallegos
• Jackie Helen Gallegos, LPC
• Jakob Gallegos
• Juan G Gallegos
• Lindalee Gallegos
• Michael Dario Gallegos, RPH
• Peggy Gallegos
• Heaven Gallimore

• Family Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.