Individual provider Active NPI

Jennifer Lynn Beam

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1720801491
Registry record updated Nov 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
55630 Issued in WY
Practice address
1301 Riverside Ave
Fort Collins, CO 80524-4374
Phone
(307) 630-4729
NPI assigned
Nov 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.1000206-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 55630 WY Primary

Addresses

Primary practice location

1301 Riverside Ave
Fort Collins, CO 80524-4374

Mailing address

PO Box 20092
Cheyenne, WY 82003-7002
Phone (307) 630-4729

Other practice location 1

2500 Dell Range Blvd
Cheyenne, WY 82009-5273
Phone (307) 630-4729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, CO2 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
I20241127003446 WY Practitioner - Nurse Practitioner 1355876343 Reassigns benefits to 1 organization
I20250606000238 CO Practitioner - Nurse Practitioner 1355876343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Liv in-Home Counseling and Care Management, LLCGroup PAC ID 5698992352, 22 clinicians

Practice addresses (Care Compare)

1301 Riverside Ave
Fort Collins, CO 80524-4374
Phone (970) 888-4070

2500 Dell Range Blvd
Cheyenne, WY 82009-5273
Phone (307) 630-4729

Hospital & facility affiliations

  • Cheyenne Regional Medical Center Hospital, Cheyenne, WY, CCN 530014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Liv in-Home Counseling & Care Management, LLC Psychiatric/Mental Health CurrentSince Dec 1, 2024 Accepting new patients
Liv in-Home Counseling & Care Management, LLC PastSince Dec 1, 2024 Accepting new patients

Locations

1301 Riverside Ave
Fort Collins, CO 80524
Phone (970) 482-3680

6631 E 2nd St
Ste 200
Casper, WY 82609
Phone (307) 277-0652

2500 Dell Range Blvd
Cheyenne, WY 82009
Phone (307) 630-4729

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1720801491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20092",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820037002",
            "telephone_number": "307-630-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244374",
            "telephone_number": "307-630-4729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Dell Range Blvd",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820095273",
            "country_code": "US",
            "telephone_number": "307-630-4729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAM",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.1000206-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WY",
            "license": "55630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.