One One Thousand LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ONE ONE THOUSAND LLC

Doing business as

The Untitled Mind Ketamine & Psychiatry

Practice address

825 S Broadway Unit 10
Boulder, CO 80305

Phone

(720) 437-9488

NPI assigned

Aug 21, 2023

Last updated

Aug 21, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adam SheelyNPI 1689955049

Title

Owner/Nurse Practitioner

Phone

(720) 437-9488

Specialties & licenses 1

Addresses

Other names 1

• The Untitled Mind Ketamine & Psychiatry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adam Sheely, ACNP-BC, PMHNP

  • Nurse Practitioner
  • Boulder, CO
  • NPI 1689955049
  NPD Authorized official

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1265216543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 BEREA DRIVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S BROADWAY UNIT 10",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80305",
            "telephone_number": "720-437-9488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 W 29th Ave Suite 320",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "80211",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ONE ONE THOUSAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-19",
        "status": "A",
        "authorized_official_last_name": "SHEELY",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "720-437-9488"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Untitled Mind Ketamine & Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Olson, LAC, LPC
• Kyle Olszewski, PHARMD
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• Philip Young On
• Alma Melisa Onassis
• Terri Dawn Oneby, OD
• Adam Oneil, PHD
• Margaret Oneil
• Onsite Anesthesia LLC
• Barbara Sweeney Oonk, RNCNP

• Psychiatric/Mental Health Nurse Practitioner in Boulder, CO
• Providers in Boulder, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.