Individual provider Active NPI

Elizabeth Ann Haselwood, MSN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Northglenn, CO
National Provider Identifier
1558012500
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0998917-NP Issued in CO
Practice address
11285 Highline Dr
Northglenn, CO 80233-3076
Phone
(303) 853-3500
NPI assigned
Jan 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 1633795 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0998917-NP CO Primary

Addresses

Primary practice location

11285 Highline Dr
Northglenn, CO 80233-3076

Mailing address

1870 W 122ND Ave Ste 100
Westminster, CO 80234-2075
Phone (303) 853-3500

Other practice location 1

4801 Riverbend Rd Ste 120B
Boulder, CO 80301-2613
Phone (303) 415-9652

Other practice location 2

8931 Huron St
Thornton, CO 80260-6806
Phone (303) 853-3500

Other identifiers 1

IdentifierTypeStateIssuer
05027008MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehaselwood@bch.org Direct Boulder Community Health

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
I20231002002715 CO Practitioner - Nurse Practitioner 2961856406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Reach Center IncGroup PAC ID 4284526971, 13 clinicians

Practice addresses (Care Compare)

11285 Highline Dr
Northglenn, CO 80233-3076
Phone (303) 853-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1633795COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Community Reach Center, Inc Current Accepting new patients
Community Reach Center, Inc CurrentSince Aug 16, 2023 Accepting new patients

Locations

11285 Highline Dr
Northglenn, CO 80233
Phone (303) 853-3400

8931 Huron St
Thornton, CO 80260
Phone (303) 853-3433

1870 W 122nd Ave
Ste 100
Westminster, CO 80234
Phone (303) 853-3800

Interoperability endpoints

  • Direct secure messaging: elizabeth.haselwood.p2@direct.communityreachcenter.nextgenshare.com

Organizations & group practices 2

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": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1558012500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W 122ND AVE STE 100",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342075",
            "telephone_number": "303-853-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11285 HIGHLINE DR",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802333076",
            "telephone_number": "303-853-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Riverbend Rd Ste 120B",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803012613",
            "country_code": "US",
            "telephone_number": "303-415-9652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8931 Huron St",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802606806",
            "country_code": "US",
            "telephone_number": "303-853-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASELWOOD",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "MSN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "1633795",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0998917-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05027008",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehaselwood@bch.org",
            "affiliation": "Y",
            "endpointDescription": "hospital email",
            "affiliationName": "Boulder Community Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "4747 Arapahoe Ave",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803031131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

Verify at the official NPI Registry.