NPIMap

Individual provider Active NPI

Marissa Kate Yoder, NP

  • Gerontology Nurse Practitioner
  • Loveland, CO
National Provider Identifier
1427514728
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APN.0994523-NP Issued in CO
Practice address
2500 Rocky Mountain Ave
Loveland, CO 80538-9004
Phone
(970) 624-1900
NPI assigned
Feb 12, 2019
Reactivated
Feb 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.1626536 CO
Gerontology Nurse Practitioner 363LG0600X APN.0994523-NP CO Primary

Addresses

Primary practice location

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

Mailing address

6455 S Yosemite St FL 6
Greenwood Village, CO 80111-5139

Other practice location 1

6455 S Yosemite St Fl 6
Greenwood Village, CO 80111-5139
Phone (970) 988-3693

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190912001155 CO Practitioner - Nurse Practitioner 9234468455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2500 Rocky Mountain Ave
Loveland, CO 80538-9004
Phone (970) 495-7421

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.1626536COMDRegistered Nurse
APN.0994523-NPCOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Mar 23, 2020 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Mar 23, 2020 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2121 E Harmony Rd
Unit 230
Fort Collins, CO 80528
Phone (970) 266-8822

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

2500 Rocky Mountain Ave
Ste 2100
Loveland, CO 80538
Phone (970) 203-7153

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

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 and National Provider Directory roles.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1427514728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 S YOSEMITE ST FL 6",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801115139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-624-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6455 S Yosemite St Fl 6",
            "address_purpose": "LOCATION",
            "city": "Greenwood Village",
            "state": "CO",
            "postal_code": "801115139",
            "country_code": "US",
            "telephone_number": "970-988-3693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YODER",
        "first_name": "MARISSA",
        "middle_name": "KATE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "deactivation_date": "2019-02-12",
        "reactivation_date": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.1626536",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0994523-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.