Individual provider Active NPI

Jessica Lauren Mamula, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1679043319
Registry record updated Mar 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0999571-NP Issued in CO
Practice address
3060 N Academy Blvd Ste 300
Colorado Springs, CO 80917-5349
Phone
(719) 900-2481
Fax
(719) 900-2483
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0999571-NP CO Primary

Addresses

Primary practice location

3060 N Academy Blvd Ste 300
Colorado Springs, CO 80917-5349

Mailing address

4419 Centennial Blvd Unit 506
Colorado Springs, CO 80907-3739
Phone (719) 900-2481

Other practice location 1

3280 E Woodmen Rd Ste 200
Colorado Springs, CO 80920-3586
Phone (719) 445-6744 ext. 530

Other practice location 2

5350 Tomah Dr Ste 1100
Colorado Springs, CO 80918-6902
Phone (719) 466-6854

Other practice location 3

219 W Colorado Ave Ste 212
Colorado Springs, CO 80903-3338
Phone (719) 445-6744 ext. 530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220204002263 CO Practitioner - Nurse Practitioner 3971849399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3060 N Academy Blvd
Suite 300
Colorado Springs, CO 80917-5349
Phone (719) 900-2481

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0999571-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harmonious Mental Health, PLLC Psychiatric/Mental Health CurrentSince Nov 22, 2023 Accepting new patients

Locations

5525 Erindale Dr
Ste 100
Colorado Springs, CO 80918
Phone (719) 313-0534

3060 N Academy Blvd
Ste 300
Colorado Springs, CO 80917
Phone (719) 828-5560

4419 Centennial Blvd
Colorado Springs, CO 80907
Phone (719) 306-0801

Interoperability endpoints

  • Direct secure messaging: jmamula53906@direct.nortonhealthcare.org

Organizations & group practices 1

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": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711238400000",
    "number": "1679043319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 CENTENNIAL BLVD UNIT 506",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073739",
            "telephone_number": "719-900-2481",
            "fax_number": "719-900-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 N ACADEMY BLVD STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175349",
            "telephone_number": "719-900-2481",
            "fax_number": "719-900-2483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3280 E Woodmen Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809203586",
            "country_code": "US",
            "telephone_number": "719-445-6744 x530",
            "fax_number": "719-960-3135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5350 Tomah Dr Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809186902",
            "country_code": "US",
            "telephone_number": "719-466-6854",
            "fax_number": "719-213-2459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "219 W Colorado Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809033338",
            "country_code": "US",
            "telephone_number": "719-445-6744 x530",
            "fax_number": "719-960-3135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMULA",
        "first_name": "JESSICA",
        "middle_name": "LAUREN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2024-03-24",
        "certification_date": "2024-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0999571-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.