Individual provider Active NPI

Katelynn Brulport

  • Family Nurse Practitioner
  • Denver, CO
National Provider Identifier
1780486795
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.1000626-NP Issued in CO
Practice address
4985 Elm CT
Denver, CO 80221-1243
Phone
(513) 550-3719
NPI assigned
Mar 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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.1000626-NP CO Primary

Addresses

Primary practice location

4985 Elm CT
Denver, CO 80221-1243

Mailing address

4985 Elm CT
Denver, CO 80221-1243
Phone (513) 550-3719

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
I20250730000653 CO Practitioner - Nurse Practitioner 9032626411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mednow Clinics, IncGroup PAC ID 0042533242, 56 clinicians

Practice addresses (Care Compare)

15101 E Iliff Ave
Suite 140
Aurora, CO 80014-4548
Phone (720) 878-7055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.1000626-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mednow Clinics, Inc CurrentSince Jun 2, 2025 Accepting new patients

Locations

15101 E Iliff Ave
Ste 140
Denver, CO 80014
Phone (303) 584-7850

Interoperability endpoints

  • Direct secure messaging: katelynn.brulport.1@14209.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1780486795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4985 ELM CT",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802211243",
            "telephone_number": "513-550-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4985 ELM CT",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802211243",
            "telephone_number": "513-550-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRULPORT",
        "first_name": "KATELYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.1000626-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.