Nicole Modesitt, BCN

Primary specialty

Other TechnicianTaxonomy code 247200000X

License

E6517 Issued in CO

Practice address

7200 S Alton Way Ste A320
Centennial, CO 80112-2254

Phone

(720) 428-8312

Fax

(720) 600-6946

NPI assigned

Jun 20, 2022

Last updated

Jun 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1245961341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 S ALTON WAY STE A320",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122254",
            "telephone_number": "720-428-8312",
            "fax_number": "720-600-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 S ALTON WAY STE A320",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122254",
            "telephone_number": "720-428-8312",
            "fax_number": "720-600-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODESITT",
        "first_name": "NICOLE",
        "credential": "BCN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "CO",
            "license": "E6517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Other Technician in Centennial, CO
• Providers in Centennial, CO by specialty
• Other Technician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.