Individual provider Active NPI

Holly Rede Geersen, D.C.

  • Rehabilitation Chiropractor
  • Aurora, CO
National Provider Identifier
1265563274
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
5527 Issued in CO
Practice address
4024 S Parker Rd
Aurora, CO 80014-4131
Phone
(303) 627-7995
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 5527 CO Primary

Addresses

Primary practice location

4024 S Parker Rd
Aurora, CO 80014-4131

Mailing address

4024 S Parker Rd
Aurora, CO 80014-4131
Phone (303) 627-7995

Other identifiers 2

IdentifierTypeStateIssuer
11513075OtherCOCAQH PIN
7264720OtherCOAETNA PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051008000157 CO Practitioner - Chiropractic 0547285512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4024 S Parker Rd
Aurora, CO 80014-4131
Phone (303) 627-7995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5527COMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Back Expert PC Rehabilitation CurrentSince Nov 8, 2005 Accepting new patients

Locations

4024 S Parker Rd
Aurora, CO 80014
Phone (303) 627-7225

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265563274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4024 S PARKER RD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800144131",
            "telephone_number": "303-627-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 S PARKER RD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800144131",
            "telephone_number": "303-627-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEERSEN",
        "first_name": "HOLLY",
        "middle_name": "REDE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CO",
            "license": "5527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PIN",
            "identifier": "11513075",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7264720",
            "state": "CO"
        }
    ],
    "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.