Individual provider Active NPI

Jennie Renee Jolliffe, RN MSN FNP-C

  • Family Nurse Practitioner
  • Hugo, CO
National Provider Identifier
1417567363
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0995752 Issued in CO
Practice address
111 6TH St
Hugo, CO 80821-2002
Phone
(719) 743-2421
NPI assigned
Aug 5, 2020
Last updated
Aug 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0995752 CO Primary

Addresses

Primary practice location

111 6TH St
Hugo, CO 80821-2002

Mailing address

17424 County Road 30.5
Stratton, CO 80836-8808
Phone (970) 302-0842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200915002532 CO Practitioner - Nurse Practitioner 6305264870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lincoln Community HospitalGroup PAC ID 8729987219, 19 clinicians

Practice addresses (Care Compare)

111 6TH St
Hugo, CO 80821-2002
Phone (713) 743-2421

111 6TH St
P O Box 248
Hugo, CO 80821-0248

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0995752COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Community Hospital CurrentSince Aug 17, 2020 Accepting new patients
Lincoln Community Hospital CurrentSince Aug 17, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1417567363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17424 COUNTY ROAD 30.5",
            "city": "STRATTON",
            "state": "CO",
            "postal_code": "808368808",
            "telephone_number": "970-302-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 6TH ST",
            "city": "HUGO",
            "state": "CO",
            "postal_code": "808212002",
            "telephone_number": "719-743-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLIFFE",
        "first_name": "JENNIE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "RN MSN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0995752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hugo, CO

Sources for this page

Verify at the official NPI Registry.