NPIMap

Individual provider Active NPI

Annaliese M Jordan, FNP

  • Family Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1760674246
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0990723-NP Issued in CO
Practice address
2121 E Harmony Rd
Ste 100
Fort Collins, CO 80528-3400
Phone
(970) 221-1000
Fax
(970) 297-6860
NPI assigned
Aug 17, 2007
Last updated
May 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0990723-NP CO
Family Nurse Practitioner 363LF0000X APN.0990723-NP CO Primary
Registered Nurse 163W00000X RN.0125748 CO

Addresses

Primary practice location

2121 E Harmony Rd
Ste 100
Fort Collins, CO 80528-3400

Mailing address

2121 E Harmony Rd
Ste 100
Fort Collins, CO 80528-3400
Phone (970) 221-1000

Other identifiers 2

IdentifierTypeStateIssuer
303146001MedicaidTX
58074228MedicaidCO

Other names 1

  • Annaliese M Schlenker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071120000174 CO Practitioner - Nurse Practitioner 3173611415 Reassigns benefits to 1 organization
I20130802000361 NE Practitioner - Nurse Practitioner 3173611415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, shared by 2 NPIs, 2,425 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Fort Collins, CO 80524-3929

11083 Colorado Blvd
Firestone, CO 80504-5873
Phone (303) 833-8880

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

2101 Box Butte Ave
Alliance, NE 69301-4445
Phone (800) 459-4241

2121 E Harmony Rd
Fort Collins, CO 80528-3401

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

3911 Ave B
Scottsbluff, NE 69361-4617
Phone (970) 482-3328

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.0125748COMDRegistered Nurse
APN.0990723-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 21, 2010 Accepting new patients
Tri-County Clinical Past Accepting new patients
Tri-County Clinical Past Accepting new patients

Locations

1024 S Lemay Ave
#F1051
Fort Collins, CO 80524

1107 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 493-7442

2121 E Harmony Rd
Unit 100
Fort Collins, CO 80528
Phone (970) 663-3107

1760 E Ken Pratt Blvd
Ste 205
Longmont, CO 80504
Phone (720) 718-3930

2500 Rocky Mountain Ave
Ste 100
Loveland, CO 80538
Phone (970) 624-1800

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

2101 Box Butte Ave
Alliance, NE 69301
Phone (308) 762-6660

2 W 42nd St
Ste 2200
Scottsbluff, NE 69361
Phone (308) 630-2626

3911 Avenue B
Scottsbluff, NE 69361
Phone (308) 630-2100

Organizations & group practices 4

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1760674246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD",
            "address_2": "STE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283400",
            "telephone_number": "970-221-1000",
            "fax_number": "970-297-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD",
            "address_2": "STE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283400",
            "telephone_number": "970-221-1000",
            "fax_number": "970-297-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ANNALIESE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0990723-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0990723-NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0125748",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303146001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58074228",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNALIESE",
            "last_name": "SCHLENKER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.