Organization Active NPI

Noco New Beginnings

  • Nurse Practitioner
  • Greeley, CO
National Provider Identifier
1720689789
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
NOCO NEW BEGINNINGS
Practice address
1019 39TH Ave Ste J
Greeley, CO 80634-2501
Phone
(970) 909-2035
Fax
(970) 909-2068
NPI assigned
Nov 5, 2020
Last updated
Nov 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Authorized official

Name
Jose Luis Vasquez, FNP-B.C., PMHNP-B.C.NPI 1649278318
Title
Owner
Phone
(970) 978-1160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

1019 39TH Ave Ste J
Greeley, CO 80634-2501

Mailing address

1019 39TH Ave Ste J
Greeley, CO 80634-2501
Phone (970) 909-2035

Other identifiers 1

IdentifierTypeStateIssuer
91002761MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201207002455 CO Part B Supplier - Clinic/Group Practice 1254743784 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Collins, CO

National Provider Directory

National Provider Directory

Locations

1019 39th Ave
Ste J
Greeley, CO 80634
Phone (970) 909-2035

1122 9th St
Ste 204
Greeley, CO 80631
Phone (970) 909-2035

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1720689789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 39TH AVE STE J",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342501",
            "telephone_number": "970-909-2035",
            "fax_number": "970-909-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 39TH AVE STE J",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342501",
            "telephone_number": "970-909-2035",
            "fax_number": "970-909-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOCO NEW BEGINNINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-978-1160",
        "authorized_official_credential": "FNP-B.C., PMHNP-B.C."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91002761",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.