Individual provider Active NPI

Stacey Jean Alldredge, RN

  • Registered Nurse
  • Denver, CO
National Provider Identifier
1790014728
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
176197 Issued in CO
Practice address
10065 E Harvard Ave
Denver, CO 80231-5968
Phone
(970) 614-1492
NPI assigned
Dec 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 176197 CO Primary

Addresses

Primary practice location

10065 E Harvard Ave
Denver, CO 80231-5968

Mailing address

134 Boutwell CT
Loveland, CO 80537-3312
Phone (970) 430-0161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
176197COMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1790014728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BOUTWELL CT",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805373312",
            "telephone_number": "970-430-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10065 E HARVARD AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802315968",
            "telephone_number": "970-614-1492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLDREDGE",
        "first_name": "STACEY",
        "middle_name": "JEAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "176197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.