Individual provider Active NPI

Deborah Herold, RN

  • Family Nurse Practitioner
  • Greenwood Village, CO
National Provider Identifier
1316272909
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0994641-NP Issued in CO
Practice address
6162 S. Willow Drive
100
Greenwood Village, CO 80111-5114
Phone
(303) 220-9200
Fax
(303) 741-4173
NPI assigned
Oct 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 182885 CO
Family Nurse Practitioner 363LF0000X APN.0994641-NP CO Primary

Addresses

Primary practice location

6162 S. Willow Drive
100
Greenwood Village, CO 80111-5114

Mailing address

6162 S. Willow Drive
Suite 100
Greenwood Village, CO 80111-5114
Phone (303) 220-9200

Other identifiers 1

IdentifierTypeStateIssuer
56672861MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200210001162 CO Practitioner - Nurse Practitioner 6204262306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inner City Health CenterGroup PAC ID 4688562697, 7 clinicians

Practice addresses (Care Compare)

6301 W 38TH Ave
Inner Cy HLTH Ctr at Wheat Ridge
Wheat Ridge, CO 80033-5057
Phone (303) 940-9118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
182885COMDRegistered Nurse
APN.0994641-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inner City Health Center CurrentSince Jan 22, 2020 Accepting new patients
Inner City Health Center CurrentSince Jan 22, 2020 Accepting new patients

Locations

3800 N York St
Denver, CO 80205
Phone (303) 296-1767

6301 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 940-9118

Interoperability endpoints

  • Direct secure messaging: deborah.herold.1@18112.direct.athenahealth.com

Organizations & group practices 2

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1316272909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6162 S. WILLOW DRIVE",
            "address_2": "SUITE 100",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801115114",
            "telephone_number": "303-220-9200",
            "fax_number": "303-220-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6162 S. WILLOW DRIVE",
            "address_2": "100",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801115114",
            "telephone_number": "303-220-9200",
            "fax_number": "303-741-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEROLD",
        "first_name": "DEBORAH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "182885",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0994641-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56672861",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

Verify at the official NPI Registry.