Individual provider Active NPI

Missouri Krantz, NP-C

  • Primary Care Nurse Practitioner
  • La Junta, CO
National Provider Identifier
1316495500
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
0992545 Issued in CO
Practice address
2215 San Juan Ave
La Junta, CO 81050-3323
Phone
(719) 363-1533
Fax
(719) 363-1534
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 0992545 CO Primary

Addresses

Primary practice location

2215 San Juan Ave
La Junta, CO 81050-3323

Mailing address

2215 San Juan Ave
La Junta, CO 81050-3323
Phone (719) 363-1533

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
I20180516000516 CO Practitioner - Nurse Practitioner 4385908532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aglands Family Health Professional LLCGroup PAC ID 7113387671, 2 clinicians

Practice addresses (Care Compare)

2215 San Juan Ave
La Junta, CO 81050-3323
Phone (719) 363-1533

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0992545COMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aglands Family Health Professional LLC CurrentSince May 1, 2023 Accepting new patients

Locations

6870 W 52nd Ave
Ste 102
Arvada, CO 80002
Phone (303) 534-0391

2215 San Juan Ave
La Junta, CO 81050
Phone (719) 363-1533

Interoperability endpoints

  • Direct secure messaging: missouri.krantz.1@28775.direct.athenahealth.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1316495500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 SAN JUAN AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810503323",
            "telephone_number": "719-363-1533",
            "fax_number": "719-363-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 SAN JUAN AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810503323",
            "telephone_number": "719-363-1533",
            "fax_number": "719-363-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRANTZ",
        "first_name": "MISSOURI",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CO",
            "license": "0992545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Junta, CO

Sources for this page

Verify at the official NPI Registry.