Individual provider Active NPI

Eric Renicker, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Aurora, CO
National Provider Identifier
1679629513
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0990535-NP Issued in CO
Practice address
11059 E Bethany Dr Ste 238
Aurora, CO 80014-2622
Phone
(303) 617-2300
Fax
(303) 617-2397
NPI assigned
Jan 25, 2007
Last updated
Jul 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 140944 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RXN.0100732-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0990535-NP CO Primary

Addresses

Primary practice location

11059 E Bethany Dr Ste 238
Aurora, CO 80014-2622

Mailing address

1290 Chambers Rd
Aurora, CO 80011-7117
Phone (303) 617-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, OR2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20151201002381 CO Practitioner - Nurse Practitioner 3779883400 Reassigns benefits to 1 organization
I20250908000393 OR Practitioner - Nurse Practitioner 3779883400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2545 N Eldorado Ave
Klamath Falls, OR 97601-6423
Phone (541) 883-3471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
140944COMDRegistered Nurse
0990535-NPCOMDPsychiatric/Mental Health Nurse Practitioner
RXN.0100732-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Whole Recovery, PC CurrentSince Dec 10, 2019 Accepting new patients
Lutheran Community Services Northwest CurrentSince Jul 1, 2025 Accepting new patients
Achieve Whole Recovery, PC CurrentSince Dec 10, 2019 Accepting new patients
Lutheran Community Services Northwest Current Accepting new patients
Lutheran Community Services Northwest CurrentSince Jul 1, 2025 Accepting new patients

Locations

1115 Elkton Dr
Ste 300
Colorado Springs, CO 80907
Phone (719) 357-6471

8380 Zuni St
Ste 305
Westminster, CO 80221
Phone (719) 357-6471

2545 N Eldorado Ave
Klamath Falls, OR 97601
Phone (541) 883-3471

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1679629513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 CHAMBERS RD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800117117",
            "telephone_number": "303-617-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11059 E BETHANY DR STE 238",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142622",
            "telephone_number": "303-617-2300",
            "fax_number": "303-617-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENICKER",
        "first_name": "ERIC",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "140944",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "RXN.0100732-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0990535-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.