Individual provider Active NPI

Jake Simpson, FNP

  • Family Nurse Practitioner
  • Lakewood, CO
National Provider Identifier
1689708018
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
114902 Issued in CO
Practice address
255 Union Blvd
Suite #120
Lakewood, CO 80228-1810
Phone
(303) 936-7415
Fax
(303) 936-2177
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 114902 CO Primary

Addresses

Primary practice location

255 Union Blvd
Suite #120
Lakewood, CO 80228-1810

Mailing address

3390 15TH St
Boulder, CO 80304-2210
Phone (303) 786-7050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114902COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Green Mountain Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21038/brand/1/csg/1/fhir/r4

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1689708018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 15TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042210",
            "telephone_number": "303-786-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 UNION BLVD",
            "address_2": "SUITE #120",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281810",
            "telephone_number": "303-936-7415",
            "fax_number": "303-936-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "JAKE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "114902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.