Shadow Mountain Mental Health

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SHADOW MOUNTAIN MENTAL HEALTH

Practice address

1200 28TH St Ste 200B
Boulder, CO 80303-1756

Phone

(505) 716-0958

Fax

(720) 684-5091

NPI assigned

Sep 17, 2019

Organization subpart

No

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

Authorized official

Name

Anne Elizabeth Miller, PMHNP-BCNPI 1881681120

Title

Psychiatric Nurse Practitioner

Phone

(505) 716-0958

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anne Elizabeth Miller, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Boulder, CO
  • NPI 1881681120
  NPD Authorized official

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1437709987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 HUMMINGBIRD CIR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805018693",
            "telephone_number": "505-716-0958",
            "fax_number": "720-684-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 28TH ST STE 200B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031756",
            "telephone_number": "505-716-0958",
            "fax_number": "720-684-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW MOUNTAIN MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "505-716-0958",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Thomas Serro, LCSW
• Kevin David Sessa, D.D.S.
• Ellen Sevigny, MA
• Andrew Durham Sewell, D.D.S.
• Mary F Shackelton, N.D.
• Brooke Shaffer, LPC
• William R. Shaffer, M.D.
• Derrick Shain, PSYCHOTHERAPIST
• Deborah Shainblum, MSW
• Amit Shakya

• Psychiatric/Mental Health Nurse Practitioner in Boulder, CO
• Providers in Boulder, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.