Individual provider Active NPI

Ghea Mae Tiping Degillo, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Littleton, CO
National Provider Identifier
1790384451
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0997474 Issued in CO
Practice address
7780 S Broadway
Littleton, CO 80122-2648
Phone
(773) 480-7883
NPI assigned
Oct 22, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209022261 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0997474 CO Primary

Addresses

Primary practice location

7780 S Broadway
Littleton, CO 80122-2648

Mailing address

7780 S Broadway Ste 300
Littleton, CO 80122-2633
Phone (773) 480-7883

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
I20230718001599 CO Practitioner - Nurse Practitioner 6406216746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

215 W Oak St
FL 4
Fort Collins, CO 80521-2734

320 W Olive St
Fort Collins, CO 80521-2716

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0997474COMDPsychiatric/Mental Health Nurse Practitioner
209022261ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Centered Counseling, PC Psychiatric/Mental Health Current Accepting new patients
Heart Centered Counseling, PC Psychiatric/Mental Health CurrentSince Jun 28, 2023 Accepting new patients
Heart Centered Counseling, PC Psychiatric/Mental Health CurrentSince Jun 28, 2023 Accepting new patients

Locations

215 W Oak St
Fl 4
Fort Collins, CO 80521
Phone (253) 346-1331

1770 25th Ave
Ste 206
Greeley, CO 80634
Phone (303) 664-5281

5941 Middlefield Rd
Ste 201
Littleton, CO 80123
Phone (303) 809-6757

7780 S Broadway
Ste 300
Littleton, CO 80122
Phone (720) 902-6747

7780 S Broadway
Littleton, CO 80122
Phone (303) 738-1100

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.gheamaedegillo@146010.advancedmd-direct.com

Organizations & group practices 3

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": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1790384451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7780 S BROADWAY STE 300",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222633",
            "telephone_number": "773-480-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7780 S BROADWAY",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222648",
            "telephone_number": "773-480-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGILLO",
        "first_name": "GHEA MAE",
        "middle_name": "TIPING",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209022261",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0997474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.