Individual provider Active NPI

Nancy K Engellenner, N.P.

  • Women's Health Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1346223898
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
ENG104260252 Issued in CO
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, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
APN.0001133-NPCOMDNurse Practitioner
ENG104260252COMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.