Amy Carol Reidhead, DC, FNP-C, BSN-RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0202308 Issued in CO

Practice address

2355 Canyon Blvd Ste 102
Boulder, CO 80302-5652

Phone

(303) 390-1245

Fax

(303) 390-1245

NPI assigned

Apr 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1629574512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 CANYON BLVD STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025652",
            "telephone_number": "303-390-1245",
            "fax_number": "303-390-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 CANYON BLVD STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025652",
            "telephone_number": "303-390-1245",
            "fax_number": "303-390-1245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4840 Riverbend Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803012633",
            "country_code": "US",
            "telephone_number": "303-449-3777",
            "fax_number": "303-449-3775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIDHEAD",
        "first_name": "AMY",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "DC, FNP-C, BSN-RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-01",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "4468",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "0202308",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0202308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regents of the University of Colorado (Speech, Language and Hearing Clinic)
• Registered Physical Therapy Associates, PC (RPT Associates, PC)
• Cassandra Lynn Reich, PHYSICAL THERAPIST
• Kevin Francis Reichlin, D.C.
• Sara Reid
• Johannah Reilly, ND, LAC
• Elise Catherine Reinhard, M.D.
• Marika Reisberg
• Alex G Reish, DO
• Releaf Therapy, LLC

• Family Nurse Practitioner in Boulder, CO
• Providers in Boulder, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.