NPIMap

Individual provider Active NPI

Lynsey Briane Mahlum, ARNP

  • Adult Health Nurse Practitioner
  • Greeley, CO
National Provider Identifier
1528362340
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APN.0991119-NP Issued in CO
Practice address
1801 16TH St
Greeley, CO 80631-5154
Phone
(970) 350-6953
Fax
(970) 350-6965
NPI assigned
Jan 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60192019 WA
Adult Health Nurse Practitioner 363LA2200X APN.0991119-NP CO Primary

Addresses

Primary practice location

1801 16TH St
Greeley, CO 80631-5154

Mailing address

1405 South 8TH Avenue
Banner Health Clinic Surgical Specialties
Sterling, CO 80751
Phone (970) 526-8123

Other identifiers 1

IdentifierTypeStateIssuer
1528362340MedicaidWA

Other names 1

  • Lynsey Briane Ridout Former name

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
I20140703000254 CO Practitioner - Nurse Practitioner 9931353521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1455 Main St
Suite 140
Windsor, CO 80550-5559
Phone (970) 686-3950

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

221 E 29TH St
Loveland, CO 80538-2746

2964 Ginnala Dr
Loveland, CO 80538-2701
Phone (970) 667-7755

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

730 14TH St SW
Loveland, CO 80537-6349
Phone (970) 663-0815

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60192019WAMDNurse Practitioner
APN.0991119-NPCOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Rooted Health Primary Care LLC Adult Health CurrentSince Jan 29, 2026 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 12, 2021 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

221 E 29th St
Ste 202
Loveland, CO 80538
Phone (970) 203-7050

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

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

Organizations & group practices 3

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 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1294444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1528362340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SOUTH 8TH AVENUE",
            "address_2": "BANNER HEALTH CLINIC SURGICAL SPECIALTIES",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "80751",
            "telephone_number": "970-526-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315154",
            "telephone_number": "970-350-6953",
            "fax_number": "970-350-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHLUM",
        "first_name": "LYNSEY",
        "middle_name": "BRIANE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-08",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60192019",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "APN.0991119-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528362340",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNSEY",
            "last_name": "RIDOUT",
            "middle_name": "BRIANE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.