NPIMap

Organization Active NPI

Radiant Health LLC

  • Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1659853174
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
990711 Issued in CO
Legal business name
RADIANT HEALTH LLC
Practice address
350 Arapahoe Ave Apt 18
Boulder, CO 80302-5843
Phone
(541) 908-3672
NPI assigned
Aug 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Authorized official

Name
Tanja Johnson, NPNPI 1467865394
Title
Administrator
Phone
(541) 908-3672

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 990711 CO Primary

Addresses

Primary practice location

350 Arapahoe Ave Apt 18
Boulder, CO 80302-5843

Mailing address

350 Arapahoe Ave Apt 18
Boulder, CO 80302-5843
Phone (541) 908-3672

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1659853174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ARAPAHOE AVE APT 18",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025843",
            "telephone_number": "541-908-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ARAPAHOE AVE APT 18",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025843",
            "telephone_number": "541-908-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TANJA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "541-908-3672",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "990711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.