NPIMap

Individual provider Active NPI

Jody Breann Pfeifer

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1386989135
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004228 Issued in CO
Practice address
1501 S Potomac St
Aurora, CO 80012-5411
Phone
(303) 695-2628
Fax
(303) 306-7753
NPI assigned
Dec 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1107457 NE
Physician Assistant 363A00000X PA.0004228 CO Primary

Addresses

Primary practice location

1501 S Potomac St
Aurora, CO 80012-5411

Mailing address

PO Box 173862
Denver, CO 80217-3862
Phone (303) 306-7783

Other identifiers 1

IdentifierTypeStateIssuer
16087771MedicaidCO

Other names 1

  • Jody B. Pfeifer Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130222000120 NE Practitioner - Physician Assistant 9032364104 Reassigns benefits to 6 organizations
I20150529002415 CO Practitioner - Physician Assistant 9032364104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Pole Creek Xing
Sidney, NE 69162-2900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1107457NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital Association CurrentSince Sep 1, 2014 Accepting new patients
Cheyenne County Hospital Association, Inc. CurrentSince Jul 23, 2015 Accepting new patients
Cheyenne County Hospital Association CurrentSince Jul 23, 2015 Accepting new patients
Phelps Memorial Health Center CurrentSince Sep 18, 2025 Accepting new patients
Phelps Memorial Health Center Physician Assistant CurrentSince Sep 1, 2021 Accepting new patients
Community Hospital Association Physician Assistant CurrentSince Sep 1, 2014 Accepting new patients

Locations

1215 Tibbals St
Holdrege, NE 68949
Phone (308) 995-2211

516 W 14th Ave
#100
Holdrege, NE 68949
Phone (308) 995-4431

1301 E H St
McCook, NE 69001
Phone (308) 344-2650

645 Osage St
Sidney, NE 69162
Phone (308) 254-5825

1000 Pole Creek Xing
Sidney, NE 69162
Phone (308) 254-5825

Interoperability endpoints

  • Direct secure messaging: jodypfeifer@pmhc.medalliesdirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1386989135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173862",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173862",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S POTOMAC ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800125411",
            "telephone_number": "303-695-2628",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFER",
        "first_name": "JODY",
        "middle_name": "BREANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-05",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1107457",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16087771",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODY",
            "last_name": "PFEIFER",
            "middle_name": "B.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.