Active NPI
Rosemary Wildeman, RN
- Registered Nurse
- Denver, CO
National Provider Identifier
1629478805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 204591
- Practice address
- 10065 E Harvard Ave
Suite 400
Denver, CO 80231-5968 - Phone
- (303) 614-1400
- NPI assigned
- Aug 25, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 204591 | CO | Primary |
Addresses
Primary practice location
10065 E Harvard Ave
Suite 400
Denver, CO 80231-5968
Mailing address
5325 W 79TH Ave Apt 3
Arvada, CO 80003-2644
Phone (720) 495-9617
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y568990 | Medicaid | CO |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 204591 | CO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409184000000",
"number": "1629478805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5325 W 79TH AVE APT 3",
"city": "ARVADA",
"state": "CO",
"postal_code": "800032644",
"telephone_number": "720-495-9617",
"fax_number": "303-427-5486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10065 E HARVARD AVE",
"address_2": "SUITE 400",
"city": "DENVER",
"state": "CO",
"postal_code": "802315968",
"telephone_number": "303-614-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDEMAN",
"first_name": "ROSEMARY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-25",
"last_updated": "2014-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CO",
"license": "204591",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Y568990",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.