Active NPI
Needlerock Family Health Clinic
- Family Nurse Practitioner
- Crawford, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 178811
- Legal business name
- NEEDLEROCK FAMILY HEALTH CLINIC
- Practice address
- 375 Elm Ave
Crawford, CO 81415-5011 - Phone
- (970) 812-6403
- NPI assigned
- Dec 24, 2009
- Last updated
- May 21, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jenny Lee Mitchell, NP
- Title
- Executive Director
- Phone
- (970) 812-6403
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 178811 | CO | Primary |
Addresses
Primary practice location
375 Elm Ave
Crawford, CO 81415-5011
Mailing address
PO Box 104
Crawford, CO 81415-0104
Phone (970) 812-6403
Other practice location 1
344 Highway 92
Crawford, CO 81415
Phone (970) 812-6403
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78255856 | Medicaid | CO |
National Provider Directory
National Provider DirectoryLocations
344 Highway 92
Crawford, CO 81415
Phone (970) 812-6403
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Crawford, CO
- NPI 1689697286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261612800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1621555200000",
"number": "1386973204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 104",
"city": "CRAWFORD",
"state": "CO",
"postal_code": "814150104",
"telephone_number": "970-812-6403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 ELM AVE",
"city": "CRAWFORD",
"state": "CO",
"postal_code": "814155011",
"telephone_number": "970-812-6403"
}
],
"practiceLocations": [
{
"address_1": "344 Highway 92",
"address_purpose": "LOCATION",
"city": "Crawford",
"state": "CO",
"postal_code": "81415",
"country_code": "US",
"telephone_number": "970-812-6403",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "NEEDLEROCK FAMILY HEALTH CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2009-12-24",
"last_updated": "2021-05-21",
"certification_date": "2021-05-21",
"status": "A",
"authorized_official_last_name": "MITCHELL",
"authorized_official_first_name": "JENNY",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "970-812-6403",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "178811",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78255856",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crawford, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.