Individual provider Active NPI

Jenny Demeaux, NP

  • Women's Health Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1689738056
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
59201 Issued in CO
Practice address
1743 Walnut St Ste 3
Boulder, CO 80302-5584
Phone
(303) 449-3777
Fax
(303) 449-3775
NPI assigned
Dec 20, 2006
Last updated
Jul 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 59201 CO Primary

Addresses

Primary practice location

1743 Walnut St Ste 3
Boulder, CO 80302-5584

Mailing address

7829 W 38TH Ave
Wheat Ridge, CO 80033-6109
Phone (303) 399-6126

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
59201COMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1689738056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7829 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336109",
            "telephone_number": "303-399-6126",
            "fax_number": "720-612-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 WALNUT ST STE 3",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025584",
            "telephone_number": "303-449-3777",
            "fax_number": "303-449-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMEAUX",
        "first_name": "JENNY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CO",
            "license": "59201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.