Individual provider Active NPI

Raeann Raisor

  • Family Nurse Practitioner
  • Broomfield, CO
National Provider Identifier
1245754738
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0101839-NP Issued in CO
Practice address
2355 W 136TH Ave
Broomfield, CO 80023-9331
Phone
(303) 658-9827
Fax
(303) 658-9828
NPI assigned
Jul 27, 2017
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11010306 FL
Family Nurse Practitioner 363LF0000X 0101204 CO
Family Nurse Practitioner 363LF0000X RXN0101204 CO
Family Nurse Practitioner 363LF0000X APN.0101839-NP CO Primary

Addresses

Primary practice location

2355 W 136TH Ave
Broomfield, CO 80023-9331

Mailing address

2355 W 136TH Ave
Broomfield, CO 80023-9331
Phone (941) 650-9363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190711002004 CO Practitioner - Nurse Practitioner 6103151204 Reassigns benefits to 2 organizations
I20231116002997 WA Practitioner - Nurse Practitioner 6103151204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Little Clinic of Colorado, LLCGroup PAC ID 5597821280, 65 clinicians

Practice addresses (Care Compare)

12959 S Parker Rd
Parker, CO 80134-3447
Phone (720) 842-4089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101204COMDFamily Nurse Practitioner
APN.0101839-NPCOMDFamily Nurse Practitioner
RXN0101204COMDFamily Nurse Practitioner
APRN11010306FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 7, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
The Little Clinic of Colorado, LLC Family CurrentSince Apr 1, 2024 Accepting new patients
Multicare Health System CurrentSince Oct 7, 2023 Accepting new patients
The Little Clinic of Colorado LLC Family PastSince Dec 1, 2024 Accepting new patients

Locations

2355 W 136th Ave
Broomfield, CO 80023
Phone (303) 658-9827

1750 W Uintah St
Colorado Springs, CO 80904
Phone (719) 325-0344

3100 S Sheridan Blvd
Denver, CO 80227
Phone (303) 742-3179

7984 W Alameda Ave
Lakewood, CO 80226
Phone (303) 459-7105

12959 S Parker Rd
Parker, CO 80134
Phone (303) 840-7683

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: raeann.raisor@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 6

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1245754738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 W 136TH AVE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239331",
            "telephone_number": "941-650-9363",
            "fax_number": "036-589-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 W 136TH AVE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239331",
            "telephone_number": "303-658-9827",
            "fax_number": "303-658-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAISOR",
        "first_name": "RAEANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11010306",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0101204",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "RXN0101204",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0101839-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.