Individual provider Active NPI

Elizabeth Anne Gerlitzki, F.N.P.

  • Adult Health Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1588763569
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APN.0004057-NP Issued in CO
Practice address
4674 Snow Mesa Dr
Suite 100
Fort Collins, CO 80528-8615
Phone
(970) 482-3712
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 23001.365 WY
Adult Health Nurse Practitioner 363LA2200X APN.0004057-NP CO Primary
Nurse Practitioner 363L00000X 4057 CO

Addresses

Primary practice location

4674 Snow Mesa Dr
Suite 100
Fort Collins, CO 80528-8615

Mailing address

2695 Rocky Mountain Ave
Suite 150
Loveland, CO 80538-8702

Other identifiers 2

IdentifierTypeStateIssuer
34829512MedicaidCO
110601502MedicaidWY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4057COMDClinical Psychologist
23001.365WYMDNurse Practitioner
APN.0004057-NPCOMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1588763569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "SUITE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-482-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERLITZKI",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WY",
            "license": "23001.365",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "APN.0004057-NP",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "4057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34829512",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110601502",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.