NPIMap

Individual provider Active NPI

Elisabeth Fabrizio, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Broomfield, CO
National Provider Identifier
1669493383
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0004490-NP Issued in CO
Practice address
12167 Sheridan Blvd
Broomfield, CO 80020-2417
Phone
(303) 658-9807
Fax
(303) 658-9808
NPI assigned
Jul 21, 2006
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 106292 CO
Family Nurse Practitioner 363LF0000X APN.0004490-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0004490-NP CO Primary

Addresses

Primary practice location

12167 Sheridan Blvd
Broomfield, CO 80020-2417

Mailing address

2620 Elm Hill Pike
Nashville, TN 37214-3108
Phone (615) 425-4193

Other identifiers 1

IdentifierTypeStateIssuer
03024369MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071219000245 CO Practitioner - Nurse Practitioner 0042274094 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2450 S Peoria
Suite 248 Virtual Behavioral Health Center
Aurora, CO 80014-5475
Phone (833) 701-0448

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0004490-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Medical Group CurrentSince Mar 31, 2019 Accepting new patients
Magnolia Medical Company CurrentSince Mar 31, 2019 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 24, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 24, 2024 Accepting new patients
Magnolia Medical Company Current Accepting new patients
Serenity TMS Centers LLC CurrentSince Aug 1, 2023 Accepting new patients
Lotus Lodge, LLC Past Accepting new patients

Locations

2450 S Peoria St
Ste 248
Aurora, CO 80014
Phone (303) 752-7747

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

10515 E 40th Ave
Ste 115
Denver, CO 80239
Phone (303) 209-5115

1850 Race St
Denver, CO 80206
Phone (303) 209-5115

2925 E Colfax Ave
Denver, CO 80206
Phone (303) 209-5115

425 S Cherry St
Fl 10
Glendale, CO 80246
Phone (720) 307-6670

255 S Routt St
Ste 250
Lakewood, CO 80228
Phone (720) 712-0300

500 Discovery Pkwy
Ste 250
Superior, CO 80027
Phone (720) 302-1505

3300 N Triumph Blvd
Ste 500
Lehi, UT 84043
Phone (801) 821-2333

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIFJBD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1669493383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108",
            "telephone_number": "615-425-4193",
            "fax_number": "615-425-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12167 SHERIDAN BLVD",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202417",
            "telephone_number": "303-658-9807",
            "fax_number": "303-658-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRIZIO",
        "first_name": "ELISABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "106292",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0004490-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0004490-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03024369",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.