Jill Vidas, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

40563 Issued in CO

Practice address

5377 Manhattan Cir
Suite 201
Boulder, CO 80303-4333

Phone

(720) 304-0083

Fax

(720) 304-0114

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1396765863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5377 MANHATTAN CIR",
            "address_2": "SUITE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034333",
            "telephone_number": "720-304-0083",
            "fax_number": "720-304-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5377 MANHATTAN CIR",
            "address_2": "SUITE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034333",
            "telephone_number": "720-304-0083",
            "fax_number": "720-304-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAS",
        "first_name": "JILL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "40563",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "40563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Elise Ververs, RD
• VI Psychiatric Services LLC
• Via Mobility Services
• Stephanie Vianelli-Nixon, MS SLP-CF
• Melissa Ann Vidaic, L. AC., DIPL. OM
• Anthony Videtto
• Andrea Viger, RDH
• Jessica Blue Sky Vigil, LPC
• Jane N Vilar, PT
• Christina Villano, R.D.

• Child & Adolescent Psychiatry Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Child & Adolescent Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.