Individual provider Active NPI

Jessica Bourassa

  • Case Manager/Care Coordinator
  • Aurora, CO
National Provider Identifier
1255809984
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
11059 E Bethany Dr
Aurora, CO 80014-2622
Phone
(303) 617-2300
Fax
(303) 617-2365
NPI assigned
Nov 12, 2018
Last updated
Dec 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

11059 E Bethany Dr
Aurora, CO 80014-2622

Mailing address

9864 Eagle River St
Littleton, CO 80125-8926
Phone (720) 999-4235

Other practice location 1

9864 Eagle River St
Littleton, CO 80125-8926
Phone (720) 999-4235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1255809984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9864 EAGLE RIVER ST",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801258926",
            "telephone_number": "720-999-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11059 E BETHANY DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142622",
            "telephone_number": "303-617-2300",
            "fax_number": "303-617-2365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9864 Eagle River St",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801258926",
            "country_code": "US",
            "telephone_number": "720-999-4235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURASSA",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.