Mary Patricia Dewald, APRN, RN, NP, CNS

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

85121 Issued in CO

Practice address

1218 Lodgepole Dr
Evergreen, CO 80439-4604

Phone

(303) 674-9355

NPI assigned

Nov 10, 2023

Last updated

Nov 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1699574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1316711229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 LODGEPOLE DR",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804394604",
            "telephone_number": "303-674-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 LODGEPOLE DR",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804394604",
            "telephone_number": "303-674-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWALD",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "APRN, RN, NP, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-10",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CO",
            "license": "0003059",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CO",
            "license": "0003059",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CO",
            "license": "85121",
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jordan Dody
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• Case Management Registered Nurse in Evergreen, CO
• Providers in Evergreen, CO by specialty
• Case Management Registered Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.