Nicole Jeanette Wilke, ANP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0990523-NP Issued in CO

Practice address

455 Kokopelli Blvd Ste C
Fruita, CO 81521-8710

Phone

(970) 256-5285

Fax

(970) 256-5290

NPI assigned

Oct 26, 2012

Last updated

Aug 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Jeanette Vandas Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24090/brand/1/csg/1/fhir/r4
• Direct secure messaging: nicole.wilke.1@24090.direct.athenahealth.com

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.

• Harmony HRT LLC

  • Family Medicine Physician
  • Fruita, CO
  • NPI 1003580564
  Medicare reassignment NPD

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

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1427301555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2497 DEMENSE AVE UNIT A",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815052407",
            "telephone_number": "970-210-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 KOKOPELLI BLVD STE C",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815218710",
            "telephone_number": "970-256-5285",
            "fax_number": "970-256-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKE",
        "first_name": "NICOLE",
        "middle_name": "JEANETTE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0990523-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "VANDAS",
            "middle_name": "JEANETTE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Ward, PTA
• Kathleen Warner, RN
• John Daniel Weirath, PT
• Western Slope Psychiatric Services LLC
• Western Valley Family Practice, PC
• Valerie Williams
• Jonah Wilson, PA
• Jill Wohlgemuth, OT
• Diana L Wright, PA-C
• Trista Wyckoff

• Family Nurse Practitioner in Fruita, CO
• Providers in Fruita, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.