Individual provider Active NPI

Sean Roche, FNP

  • Family Nurse Practitioner
  • Durango, CO
National Provider Identifier
1679001036
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0993212 Issued in CO
Practice address
14 Calico TRL
Durango, CO 81301-8422
Phone
(970) 501-5999
Fax
(970) 422-4023
NPI assigned
May 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0993212-NP CO
Family Nurse Practitioner 363LF0000X 201900239RN OR
Family Nurse Practitioner 363LF0000X 201900774NP-PP OR
Family Nurse Practitioner 363LF0000X 0993212 CO Primary

Addresses

Primary practice location

14 Calico TRL
Durango, CO 81301-8422

Mailing address

160 E 12TH St Ste 1
Durango, CO 81301-5261
Phone (970) 501-5999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, OR, MT, NM4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20170906000760 CO Practitioner - Nurse Practitioner 8820361355
I20190306002934 OR Practitioner - Nurse Practitioner 8820361355 Reassigns benefits to 1 organization
I20220705001078 MT Practitioner - Nurse Practitioner 8820361355 Reassigns benefits to 1 organization
I20230728003154 NM Practitioner - Nurse Practitioner 8820361355

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0993212-NPCOMDNurse Practitioner
0993212COMDFamily Nurse Practitioner
201900239RNORMDFamily Nurse Practitioner
201900774NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icco LLC CurrentSince Apr 1, 2019 Accepting new patients
Peak Health & Wellness, LLC CurrentSince Jun 1, 2022 Accepting new patients
Icco, LLC CurrentSince Apr 1, 2019 Accepting new patients
Icco, LLC Current Accepting new patients

Locations

403 W Main St
Belgrade, MT 59714
Phone (406) 388-8708

1800 Coburg Rd
Eugene, OR 97401
Phone (541) 342-1632

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

1292 High St
Eugene, OR 97401
Phone (541) 636-3473

5781 Main St
Springfield, OR 97478
Phone (541) 284-1694

87983 Territorial Rd
Veneta, OR 97487
Phone (541) 935-2200

Interoperability endpoints

  • Direct secure messaging: sean.roche@935528919728132.direct.elationemr.com
  • Direct secure messaging: sean.roche@202362935902212.direct.elationemr.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1679001036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E 12TH ST STE 1",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015261",
            "telephone_number": "970-501-5999",
            "fax_number": "970-422-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 CALICO TRL",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018422",
            "telephone_number": "970-501-5999",
            "fax_number": "970-422-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "SEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0993212-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201900239RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201900774NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0993212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.