Individual provider Active NPI

John K Vermilyen, NP

  • Family Nurse Practitioner
  • Broomfield, CO
National Provider Identifier
1750399580
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0003609-NP Issued in CO
Practice address
4590 W 121St Ave
Broomfield, CO 80020-5666
Phone
(303) 439-4544
Fax
(303) 439-9363
NPI assigned
Aug 4, 2006
Last updated
Sep 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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 APN.0003609-NP CO Primary

Addresses

Primary practice location

4590 W 121St Ave
Broomfield, CO 80020-5666

Mailing address

2550 N. Thunderbird Circle
Ste. 303
Mesa, AZ 85215-1219
Phone (888) 705-8558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000332 CO Practitioner - Nurse Practitioner 6204851223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Lakewood IncGroup PAC ID 9739486374, 24 clinicians

Practice addresses (Care Compare)

12105 W Alameda Pkwy
Suite 100
Lakewood, CO 80228-2832
Phone (303) 988-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0003609-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Lakewood Inc CurrentSince Sep 1, 2019 Accepting new patients
Urgent Care Lakewood Inc CurrentSince Sep 1, 2019 Accepting new patients
Highlands Ranch Healthcare LLC Past Accepting new patients

Locations

12105 W Alameda Pkwy
Ste 100
Lakewood, CO 80228
Phone (303) 988-3600

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1750399580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N. THUNDERBIRD CIRCLE",
            "address_2": "STE. 303",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151219",
            "telephone_number": "888-705-8558",
            "fax_number": "480-832-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 W 121ST AVE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800205666",
            "telephone_number": "303-439-4544",
            "fax_number": "303-439-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMILYEN",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0003609-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.