Individual provider Active NPI

Jette Rosholm Hogenmiller, PHD, MN, ARNP, CDE

  • Family Nurse Practitioner
  • Parker, CO
National Provider Identifier
1447560065
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
C-APN.0100085-C-NP Issued in CO
Practice address
12230 Lioness Way
Parker, CO 80134-5603
Phone
(720) 644-9355
NPI assigned
Oct 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 110088 NE
Family Nurse Practitioner 363LF0000X 025803 A099882 IA
Family Nurse Practitioner 363LF0000X AP 3000 3517 WA
Family Nurse Practitioner 363LF0000X 2010009933 MO
Family Nurse Practitioner 363LF0000X AP30003517 WA
Family Nurse Practitioner 363LF0000X C-APN.0100085-C-NP CO Primary

Addresses

Primary practice location

12230 Lioness Way
Parker, CO 80134-5603

Mailing address

9250 E Costilla Ave Ste 540
Greenwood Village, CO 80112-3648
Phone (720) 644-9355

Other practice location 1

80 Health Park Dr
Suite 270
Louisville, CO 80027-9584
Phone (303) 661-1860

Other identifiers 1

IdentifierTypeStateIssuer
47-06671-511MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160422000681 CO Practitioner - Nurse Practitioner 1850690009 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
025803 A099882IAMDFamily Nurse Practitioner
2010009933MOMDFamily Nurse Practitioner
110088NEMDFamily Nurse Practitioner
AP 3000 3517WAMDFamily Nurse Practitioner
AP30003517WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Consultants PLLC CurrentSince Mar 1, 2024 Accepting new patients
Portercare Adventist Health System CurrentSince Apr 1, 2016 Accepting new patients
Portercare Adventist Health System CurrentSince Apr 1, 2016 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Summit Medical Consultants Aco Prof LLC Current Accepting new patients
Careconnectmd Colorado Inc. CurrentSince Feb 1, 2025 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

9250 E Costilla Ave
Ste 540
Greenwood Village, CO 80112

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

80 Health Park Dr
Ste 270
Louisville, CO 80027
Phone (303) 269-2085

12230 Lioness Way
Parker, CO 80134
Phone (720) 214-7777

373 E 10th Ave
Springfield, CO 81073
Phone (719) 523-4501

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1287187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1447560065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 E COSTILLA AVE STE 540",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801123648",
            "telephone_number": "720-644-9355",
            "fax_number": "303-661-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 LIONESS WAY",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801345603",
            "telephone_number": "720-644-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Health Park Dr",
            "address_2": "Suite 270",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800279584",
            "country_code": "US",
            "telephone_number": "303-661-1860",
            "fax_number": "303-661-1861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOGENMILLER",
        "first_name": "JETTE",
        "middle_name": "ROSHOLM",
        "credential": "PHD, MN, ARNP, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-16",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110088",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "025803 A099882",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP 3000 3517",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2010009933",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30003517",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0100085-C-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-06671-511",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.