Organization Active NPI

Jean T. Masterson, D.P.M.

  • Podiatrist
  • Greeley, CO
National Provider Identifier
1669642443
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
JEAN T. MASTERSON, D.P.M.
Practice address
2000 16TH St Ste 3
Greeley, CO 80631-5149
Phone
(970) 352-4815
NPI assigned
Mar 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Dr. Jean Therese Masterson, D.P.M.
Title
Ownner
Phone
(970) 352-4815

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

2000 16TH St Ste 3
Greeley, CO 80631-5149

Mailing address

2000 16TH St Ste 3
Greeley, CO 80631-5149
Phone (970) 352-4815

Other identifiers 1

IdentifierTypeStateIssuer
01003706MedicaidCO

National Provider Directory

National Provider Directory

Locations

2000 16th St
Ste 3
Greeley, CO 80631
Phone (970) 352-4815

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1669642443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 16TH ST STE 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315149",
            "telephone_number": "970-352-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 16TH ST STE 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315149",
            "telephone_number": "970-352-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN T. MASTERSON, D.P.M.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "OWNNER",
        "authorized_official_telephone_number": "970-352-4815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01003706",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.