Individual provider Active NPI

Hernando A Mispireta, ACNPC

  • Gerontology Nurse Practitioner
  • Thornton, CO
National Provider Identifier
1578796355
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APN.991183-NP Issued in CO
Practice address
445 E 124TH Ave
Thornton, CO 80241-2402
Phone
(303) 327-1189
Fax
(303) 327-1197
NPI assigned
Aug 27, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP-02455 NM
Acute Care Nurse Practitioner 363LA2100X ARNP9217836 FL
Critical Care Medicine Nurse Practitioner 363LC0200X CNP-02455 NM
Gerontology Nurse Practitioner 363LG0600X APN.991183-NP CO Primary
Gerontology Clinical Nurse Specialist 364SG0600X APN 0991183-NP CO

Addresses

Primary practice location

445 E 124TH Ave
Thornton, CO 80241-2402

Mailing address

8950 E Lowry Blvd
Innovage Lowry Attn: Gayle Washington
Denver, CO 80230-7030
Phone (303) 869-4664

Other practice location 1

8044 Conifer Rd
Denver, CO 80221-4512
Phone (305) 342-6623

Other practice location 2

8044 Conifer Rd
Denver, CO 80221-4512
Phone (305) 342-6623

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP-02455NMMDNurse Practitioner
ARNP9217836FLMDAcute Care Nurse Practitioner
APN.991183-NPCOMDGerontology Nurse Practitioner
APN 0991183-NPCOMDGerontology Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578796355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 E LOWRY BLVD",
            "address_2": "INNOVAGE LOWRY ATTN: GAYLE WASHINGTON",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307030",
            "telephone_number": "303-869-4664",
            "fax_number": "303-996-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E 124TH AVE",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412402",
            "telephone_number": "303-327-1189",
            "fax_number": "303-327-1197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8044 Conifer Rd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802214512",
            "country_code": "US",
            "telephone_number": "305-342-6623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8044 Conifer Rd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802214512",
            "country_code": "US",
            "telephone_number": "305-342-6623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISPIRETA",
        "first_name": "HERNANDO",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "ACNPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-02455",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP9217836",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "NM",
            "license": "CNP-02455",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.991183-NP",
            "primary": true
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "CO",
            "license": "APN 0991183-NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.