Individual provider Active NPI

Kristina Dennise Mordecai

  • Psychiatric/Mental Health Nurse Practitioner
  • Denver, CO
National Provider Identifier
1376791442
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0998186-NP Issued in CO
Practice address
4155 E Jewell Ave Ste 600
Denver, CO 80222-4510
Phone
(720) 310-2773
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0998186-NP CO Primary
Registered Nurse 163W00000X 128167 CO

Addresses

Primary practice location

4155 E Jewell Ave Ste 600
Denver, CO 80222-4510

Mailing address

4155 E Jewell Ave Ste 600
Denver, CO 80222-4510
Phone (303) 783-4734

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
128167COMDRegistered Nurse
APN.0998186-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
National Mental Health Management, LLC PastSince Mar 22, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kristina.mordecai.1@21279.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1376791442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 E JEWELL AVE STE 600",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802224510",
            "telephone_number": "303-783-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 E JEWELL AVE STE 600",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802224510",
            "telephone_number": "720-310-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORDECAI",
        "first_name": "KRISTINA",
        "middle_name": "DENNISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0998186-NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "128167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.