Individual provider Active NPI

Melissa J Guerri, PA-C, M.S.

  • Medical Physician Assistant
  • Broomfield, CO
National Provider Identifier
1295068682
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2975 Issued in CO
Practice address
403 Summit Blvd Unit 204
Broomfield, CO 80021-8253
Phone
(720) 401-2139
Fax
(303) 469-4439
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2975 CO Primary

Addresses

Primary practice location

403 Summit Blvd Unit 204
Broomfield, CO 80021-8253

Mailing address

403 Summit Blvd Unit 204
Broomfield, CO 80021-8253
Phone (720) 401-2139

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)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
2975COMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1295068682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 SUMMIT BLVD UNIT 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218253",
            "telephone_number": "720-401-2139",
            "fax_number": "303-469-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 SUMMIT BLVD UNIT 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218253",
            "telephone_number": "720-401-2139",
            "fax_number": "303-469-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRI",
        "first_name": "MELISSA",
        "middle_name": "J",
        "credential": "PA-C, M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.