Individual provider Active NPI

Kelsey Nicole Froom, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1487388435
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0997752-NP Issued in CO
Practice address
4770 Baseline Rd Ste 300
Boulder, CO 80303-2669
Phone
(720) 798-4516
NPI assigned
Jul 14, 2022
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2366928 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0997752-NP CO Primary

Addresses

Primary practice location

4770 Baseline Rd Ste 300
Boulder, CO 80303-2669

Mailing address

5145 Preston PL
Brunswick, OH 44212-4776
Phone (440) 478-9067

Other practice location 1

361 Newbury St Fl 5
Boston, MA 02115-2727
Phone (617) 865-4910

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231211001943 CO Practitioner - Nurse Practitioner 1557738804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joseph Yeretsian PCGroup PAC ID 5597893313, 13 clinicians

Practice addresses (Care Compare)

155 Boardwalk Dr
Suite 400
Fort Collins, CO 80525-3040
Phone (970) 549-0235

4770 Baseline Rd
Suite 300
Boulder, CO 80303-2669
Phone (720) 798-4516

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2366928MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Yeretsian, P.C. CurrentSince Sep 5, 2023 Accepting new patients

Locations

4770 Baseline Rd
Ste 300
Boulder, CO 80303
Phone (720) 798-4516

155 Boardwalk Dr
Ste 400
Fort Collins, CO 80525
Phone (970) 549-0235

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1487388435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5145 PRESTON PL",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442124776",
            "telephone_number": "440-478-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 BASELINE RD STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032669",
            "telephone_number": "720-798-4516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "361 Newbury St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021152727",
            "country_code": "US",
            "telephone_number": "617-865-4910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FROOM",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2366928",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0997752-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.