Individual provider Active NPI

Christina Rae Irelan, FNP-BC

  • Family Nurse Practitioner
  • Denver, CO
National Provider Identifier
1356729651
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0992141 Issued in CO
Practice address
3212 Tejon St
Denver, CO 80211-3431
Phone
(303) 953-5169
NPI assigned
May 7, 2015
Last updated
May 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0992141 CO Primary
Registered Nurse 163W00000X 0192701 CO

Addresses

Primary practice location

3212 Tejon St
Denver, CO 80211-3431

Mailing address

3212 Tejon St
Denver, CO 80211-3431
Phone (303) 953-5169

Other identifiers 2

IdentifierTypeStateIssuer
7315225463OtherPECOS PAC ID
I20161025001982OtherPECOS ENROLLMENT ID

Other names 1

  • Miss Christina Rae Aguilar Former name

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
I20161025001982 CO Practitioner - Nurse Practitioner 7315225463 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0192701COMDRegistered Nurse
0992141COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Colorado, LLC Family CurrentSince Oct 18, 2016 Accepting new patients

Locations

2355 W 136th Ave
Broomfield, CO 80023
Phone (303) 658-9827

2810 Quebec St
Denver, CO 80207
Phone (303) 333-3837

7984 W Alameda Ave
Lakewood, CO 80226
Phone (303) 459-7105

17761 Cottonwood Dr
Parker, CO 80134
Phone (303) 334-9540

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

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": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1356729651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 TEJON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802113431",
            "telephone_number": "303-953-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 TEJON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802113431",
            "telephone_number": "303-953-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRELAN",
        "first_name": "CHRISTINA",
        "middle_name": "RAE",
        "name_prefix": "Miss",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0992141",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "0192701",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECOS PAC ID",
            "identifier": "7315225463",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECOS ENROLLMENT ID",
            "identifier": "I20161025001982",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "AGUILAR",
            "middle_name": "RAE",
            "prefix": "MISS",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.