Individual provider Active NPI

Rochelle D Petitjean, CRNA

  • Certified Registered Nurse Anesthetist
  • Lakewood, CO
National Provider Identifier
1629066709
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
047051 Issued in TX
Practice address
13772 Denver West Pkwy
Building 55, Suite 100
Lakewood, CO 80401-3139
Phone
(303) 279-6600
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
Yes

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.

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
047051TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Specialists of Houston, L.L.P. Past Accepting new patients
Anesthesia Specialists of Houston, L.L.P Past Accepting new patients
Anesthesia Associates of the Rockies LLC Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 047051 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

13772 Denver West Pkwy
Building 55, Suite 100
Lakewood, CO 80401-3139

Mailing address

2572 S Franklin St
Denver Co 80210
Denver, CO 80210-5110
Phone (720) 570-0717

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0890576-02MedicaidTX

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629066709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2572 S FRANKLIN ST",
            "address_2": "DENVER CO 80210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802105110",
            "telephone_number": "720-570-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13772 DENVER WEST PKWY",
            "address_2": "BUILDING 55, SUITE 100",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013139",
            "telephone_number": "303-279-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETITJEAN",
        "first_name": "ROCHELLE",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "047051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0890576-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.