Individual provider Active NPI

Jonathan Richard Meacham, FNP

  • Nurse Practitioner
  • Fountain, CO
National Provider Identifier
1760153779
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0996942 Issued in CO
Practice address
6908 Mesa Ridge Pkwy
Fountain, CO 80817-1533
Phone
(719) 471-2273
Fax
(719) 325-8971
NPI assigned
Sep 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0996942 CO Primary

Addresses

Primary practice location

6908 Mesa Ridge Pkwy
Fountain, CO 80817-1533

Mailing address

6908 Mesa Ridge Pkwy
Fountain, CO 80817-1533
Phone (719) 471-2273

Other practice location 1

2551 W 84th Ave
Westminster, CO 80031-3807
Phone (303) 561-5193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0996942COMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1760153779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6908 MESA RIDGE PKWY",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171533",
            "telephone_number": "719-471-2273",
            "fax_number": "719-325-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6908 MESA RIDGE PKWY",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171533",
            "telephone_number": "719-471-2273",
            "fax_number": "719-325-8971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2551 W 84th Ave",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "CO",
            "postal_code": "800313807",
            "country_code": "US",
            "telephone_number": "303-561-5193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEACHAM",
        "first_name": "JONATHAN",
        "middle_name": "RICHARD",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-21",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "0996942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain, CO

Sources for this page

Verify at the official NPI Registry.