Jennifer R Jergerian, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY.0003310 Issued in CO

Practice address

4601 Corbett Dr
Fort Collins, CO 80528-9579

Phone

(970) 207-4857

Fax

(970) 207-4885

NPI assigned

Mar 22, 2007

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

Other identifiers 2

Other names 1

• Jennifer R Engle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Poudre Valley Health Care Inc

  dba Poudre Valley Health System

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1962158857
  NPD
• Poudre Valley Health Care Inc.

  dba Poudre Valley Hospital

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1760492714
  NPD

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1306962915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 CORBETT DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289579",
            "telephone_number": "970-207-4857",
            "fax_number": "970-207-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 CORBETT DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289579",
            "telephone_number": "970-207-4857",
            "fax_number": "970-207-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERGERIAN",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "3843",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY.0003310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "015957",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97282774",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ENGLE",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nathalie Jensen
• Noel C Jensen, L.AC.
• Spencer Lynn Jensen
• Barbara Jenson
• Jeremy T. Sharp, PH.D., LLC
• Geraldine Victoria Jerome, M.D.
• Thadeus Collins Jessen, LPC
• Mari Jesser
• Jessica Grant, LCSW LLC
• Jessica Kraus LMT

• Psychologist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.