Active NPI
Sean Wallis, NP
- Nurse Practitioner
- Boulder, CO
National Provider Identifier
1356980205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APN.0995133-NP
- Practice address
- 4747 Arapahoe Ave
Boulder, CO 80303-1131 - Phone
- (303) 415-7000
- NPI assigned
- Dec 24, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APN.0995133-NP | CO | Primary |
Addresses
Primary practice location
4747 Arapahoe Ave
Boulder, CO 80303-1131
Mailing address
8769 W Cornell Ave Apt 3
Lakewood, CO 80227-4820
Phone (720) 325-4228
Other names 1
- Sean M Pippitt
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://my.bch.org/MyChartPRD/ | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-7610
Hospital & facility affiliations
- Boulder Community Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN.0995133-NP | CO | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients |
Locations
4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000
1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Boulder, CO
- NPI 1821074196
-
- Urgent Care Clinic/Center
- Erie, CO
- NPI 1174179964
-
- Primary Care Clinic/Center
- Boulder, CO
- NPI 1740837137
-
- Medical Specialty Clinic/Center
- Boulder, CO
- NPI 1407685498
-
- Multi-Specialty Clinic/Center
- Boulder, CO
- NPI 1609822030
Hospital & facility affiliations 34
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Boulder, CO
- NPI 1093357907
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702944000000",
"number": "1356980205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8769 W CORNELL AVE APT 3",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802274820",
"telephone_number": "720-325-4228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4747 ARAPAHOE AVE",
"city": "BOULDER",
"state": "CO",
"postal_code": "803031131",
"telephone_number": "303-415-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLIS",
"first_name": "SEAN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-24",
"last_updated": "2023-12-19",
"certification_date": "2023-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "APN.0995133-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://my.bch.org/MyChartPRD/",
"affiliation": "N",
"endpointDescription": "Patient Portal",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "MyBCH",
"address_1": "4747 Arapahoe Ave",
"city": "Boulder",
"state": "CO",
"country_code": "US",
"postal_code": "803031131",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SEAN",
"last_name": "PIPPITT",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}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 Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.