Active NPI
Nancy K Engellenner, N.P.
- Women's Health Nurse Practitioner
- Boulder, CO
National Provider Identifier
1346223898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- ENG104260252
- Practice address
- 4745 Arapahoe Ave Ste 320
Boulder, CO 80303-1082 - Phone
- (303) 441-0587
- Fax
- (303) 996-0801
- NPI assigned
- Nov 29, 2005
- Last updated
- Mar 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APN.0001133-NP | CO | |
| Women's Health Nurse Practitioner | 363LW0102X | ENG104260252 | CO | Primary |
Addresses
Primary practice location
4745 Arapahoe Ave Ste 320
Boulder, CO 80303-1082
Mailing address
5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 441-0587
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN.0001133-NP | CO | MD | Nurse Practitioner |
| ENG104260252 | CO | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Community Health | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Community Medical Associates of BCH
- Medical Specialty Clinic/Center
- Boulder, CO
- NPI 1407685498
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520553600000",
"number": "1346223898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5450 WESTERN AVE",
"city": "BOULDER",
"state": "CO",
"postal_code": "803012709",
"telephone_number": "303-441-0587",
"fax_number": "303-996-0801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4745 ARAPAHOE AVE STE 320",
"city": "BOULDER",
"state": "CO",
"postal_code": "803031082",
"telephone_number": "303-441-0587",
"fax_number": "303-996-0801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGELLENNER",
"first_name": "NANCY",
"middle_name": "K",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-29",
"last_updated": "2018-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "APN.0001133-NP",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CO",
"license": "ENG104260252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.