Individual provider Active NPI

Cindy Sue Kisselman, BSN RN

  • Community Health Registered Nurse
  • Lakewood, CO
National Provider Identifier
1396818019
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
111507 Issued in CO
Practice address
260 S Kipling St
Jefferson Co Dept of Health & Environment
Lakewood, CO 80226-1086
Phone
(303) 239-7019
Fax
(303) 239-7088
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 111507 CO Primary

Addresses

Primary practice location

260 S Kipling St
Jefferson Co Dept of Health & Environment
Lakewood, CO 80226-1086

Mailing address

7702 S Cottonwood Mountain
Littleton, CO 80127-3986
Phone (303) 904-3729

Other identifiers 1

IdentifierTypeStateIssuer
07111503MedicaidCO

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
111507COMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396818019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 S COTTONWOOD MOUNTAIN",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801273986",
            "telephone_number": "303-904-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 S KIPLING ST",
            "address_2": "JEFFERSON CO DEPT OF HEALTH & ENVIRONMENT",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802261086",
            "telephone_number": "303-239-7019",
            "fax_number": "303-239-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSELMAN",
        "first_name": "CINDY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "BSN RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CO",
            "license": "111507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07111503",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.