NPIMap

Individual provider Active NPI

Jennifer Rae Young, PA-C

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1760930283
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004726 Issued in CO
Practice address
2127 E Harmony Rd Ste 140
Fort Collins, CO 80528-3406
Phone
(970) 297-6250
Fax
(970) 297-6260
NPI assigned
Sep 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0004726 CO Primary

Addresses

Primary practice location

2127 E Harmony Rd Ste 140
Fort Collins, CO 80528-3406

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2409

Other names 1

  • Jennifer Rae Hendricks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY2 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
I20190108002229 CO Practitioner - Physician Assistant 3476899717 Reassigns benefits to 3 organizations
I20220406002462 WY Practitioner - Physician Assistant 3476899717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1100 E Prospect Rd
BLDG a
Fort Collins, CO 80525-5304
Phone (970) 297-6630

1106 E Prospect Rd
Building B Suite 100
Fort Collins, CO 80525-5304
Phone (970) 495-7410

2127 E Harmony Rd
Suite 140 Uchmg Harmony Urgent Care
Fort Collins, CO 80528-3406
Phone (970) 297-6250

221 E 29TH St
Loveland, CO 80538-2746

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

4846 Larimer Pkwy
BLDG 1
Johnstown, CO 80534-9012
Phone (970) 624-2830

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince May 30, 2023 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

5965 Firestone Blvd
Bldg B
Firestone, CO 80504
Phone (720) 652-7055

5965 Firestone Blvd
Firestone, CO 80504
Phone (720) 652-7055

3519 Richmond Dr
Fort Collins, CO 80526
Phone (970) 204-0300

2127 E Harmony Rd
Ste 140
Fort Collins, CO 80528
Phone (970) 207-4800

1113 Oakridge Dr
Fort Collins, CO 80525
Phone (970) 225-0040

5881 W 16th St
Ste A
Greeley, CO 80634
Phone (970) 313-2700

4846 Larimer Pkwy
Bldg 1
Johnstown, CO 80534
Phone (970) 624-2830

2970 Arapahoe Rd
Lafayette, CO 80026
Phone (303) 460-6010

2101 Main St
Longmont, CO 80501
Phone (720) 745-8020

1159 Eagle Dr
Loveland, CO 80537
Phone (970) 219-5223

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

221 E 29th St
Ste 102
Loveland, CO 80538
Phone (970) 224-3636

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 and National Provider Directory roles.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1760930283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-2409",
            "fax_number": "970-490-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 E HARMONY RD STE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283406",
            "telephone_number": "970-297-6250",
            "fax_number": "970-297-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HENDRICKS",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.