NPIMap

Individual provider Active NPI

Kristen Elaine Cleavelin, FNP-C

  • Family Nurse Practitioner
  • Thornton, CO
National Provider Identifier
1487199733
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
C-APN.0002782-C-NP Issued in CO
Practice address
13631 Colorado Blvd
Thornton, CO 80602-7051
Phone
(303) 252-2960
Fax
(303) 525-2964
NPI assigned
Dec 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2009004960 MO
Registered Nurse 163W00000X 650210 NY
Family Nurse Practitioner 363LF0000X 2016033669 MO
Family Nurse Practitioner 363LF0000X C-APN.0002782-C-NP CO Primary

Addresses

Primary practice location

13631 Colorado Blvd
Thornton, CO 80602-7051

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4123

Other practice location 1

Mercy convenient Care
901 Patients First Drive
Washington, MO 63090
Phone (636) 390-1777

Other identifiers 1

IdentifierTypeStateIssuer
1487199733MedicaidMO

Other names 1

  • Kristen Elaine Williams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170119001506 MO Practitioner - Nurse Practitioner 4880976273 Reassigns benefits to 1 organization
I20220406002002 CO Practitioner - Nurse Practitioner 4880976273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
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)

13631 Colorado Blvd
Thornton, CO 80602-7051
Phone (303) 252-2960

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009004960MOMDRegistered Nurse
650210NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Apr 11, 2022 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jan 1, 2017 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jan 1, 2017 Accepting new patients
St Louis Pathology Assoc Inc. Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Apr 11, 2022 Accepting new patients
Uchealth Community Services Past Accepting new patients

Locations (25 of 26)

15240 W 64th Ave
Arvada, CO 80007
Phone (303) 463-7180

16951 E Quincy Ave
Aurora, CO 80015
Phone (303) 752-5470

4404 Barranca Ln
Unit 101
Castle Rock, CO 80104
Phone (720) 733-5260

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

4404 Barranca Ln
Ste 101
Castle Rock, CO 80104
Phone (720) 733-5260

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

311 Steele St
Denver, CO 80206
Phone (303) 372-4000

5589 Argonne St
Denver, CO 80249
Phone (303) 371-0330

4660 Yosemite St
Ste 100
Denver, CO 80238
Phone (720) 516-8900

5965 Firestone Blvd
Firestone, CO 80504
Phone (720) 652-7055

5965 Firestone Blvd
Bldg B
Firestone, CO 80504
Phone (720) 652-7055

2127 E Harmony Rd
Ste 140
Fort Collins, CO 80528
Phone (970) 207-4800

9475 S University Blvd
Highlands Ranch, CO 80126
Phone (303) 470-4061

4846 Larimer Pkwy
Bldg 1
Johnstown, CO 80534
Phone (970) 624-2830

2970 Arapahoe Rd
Lafayette, CO 80026
Phone (303) 460-6010

8155 Piney River Ave
Ste 100
Littleton, CO 80125
Phone (303) 265-3370

2101 Main St
Longmont, CO 80501
Phone (720) 745-8020

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

1159 Eagle Dr
Loveland, CO 80537
Phone (970) 219-5223

221 E 29th St
Ste 102
Loveland, CO 80538
Phone (970) 224-3636

13631 Colorado Blvd
Thornton, CO 80602
Phone (303) 252-2960

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

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.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1487199733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4123",
            "fax_number": "706-242-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13631 COLORADO BLVD",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "806027051",
            "telephone_number": "303-252-2960",
            "fax_number": "303-525-2964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Mercy convenient Care",
            "address_2": "901 Patients First Drive",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "63090",
            "country_code": "US",
            "telephone_number": "636-390-1777",
            "fax_number": "636-390-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEAVELIN",
        "first_name": "KRISTEN",
        "middle_name": "ELAINE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2009004960",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "650210",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016033669",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0002782-C-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487199733",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "WILLIAMS",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.