NPIMap

Organization Active NPI

Well Nourished LLC

  • Adult Mental Health Clinic/Center
  • Golden, CO
National Provider Identifier
1598409468
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
WELL NOURISHED LLC
Practice address
2801 Youngfield St Ste 101
Golden, CO 80401-0208
Phone
(720) 241-2489
NPI assigned
Apr 26, 2022
Last updated
Jul 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Authorized official

Name
Hope Manning, PA-C, CAQ-PSYCHNPI 1477028793
Title
PA-C
Phone
(720) 241-2489

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

2801 Youngfield St Ste 101
Golden, CO 80401-0208

Mailing address

2801 Youngfield St Ste 101
Golden, CO 80401-0208
Phone (720) 241-2489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230222002974 CO Part B Supplier - Clinic/Group Practice 6608249669 Receives reassigned benefits from 12 practitioners
Practice locations: Golden, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2327507Well Nourished LLC2801 Youngfield St, Suite 101, Golden, CO 80401Certificate of waiverJul 22, 2027

National Provider Directory

National Provider Directory

Locations

2801 Youngfield St
Ste 101
Golden, CO 80401
Phone (720) 512-1215

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1598409468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 YOUNGFIELD ST STE 101",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804010208",
            "telephone_number": "720-241-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 YOUNGFIELD ST STE 101",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804010208",
            "telephone_number": "720-241-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL NOURISHED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "HOPE",
        "authorized_official_title_or_position": "PA-C",
        "authorized_official_telephone_number": "720-241-2489",
        "authorized_official_credential": "PA-C, CAQ-PSYCH"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.