Individual provider Active NPI

Geraldine Victoria Jerome, M.D.

  • Psychiatry Physician
  • Fort Collins, CO
National Provider Identifier
1689643702
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DR.0038549 Issued in CO
Practice address
4601 Corbett Dr
Fort Collins, CO 80528-9579
Phone
(970) 207-4857
Fax
(970) 207-4885
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DR.0038549 CO Primary

Addresses

Primary practice location

4601 Corbett Dr
Fort Collins, CO 80528-9579

Mailing address

4601 Corbett Dr
Fort Collins, CO 80528-9579
Phone (970) 207-4857

Other identifiers 1

IdentifierTypeStateIssuer
70758816MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0038549COMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Health Care Inc. Current Accepting new patients

Locations

2315 E Harmony Rd
Ste 200
Fort Collins, CO 80528

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1689643702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 CORBETT DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289579",
            "telephone_number": "970-207-4857",
            "fax_number": "970-207-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 CORBETT DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289579",
            "telephone_number": "970-207-4857",
            "fax_number": "970-207-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "GERALDINE",
        "middle_name": "VICTORIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0038549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70758816",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.