Individual provider Active NPI

Jayson J Pfister

  • Addiction (Substance Use Disorder) Counselor
  • Boulder, CO
National Provider Identifier
1790452779
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
2833 Broadway St
Boulder, CO 80304-3544
Phone
(303) 449-2217
NPI assigned
Aug 26, 2021
Last updated
Aug 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

2833 Broadway St
Boulder, CO 80304-3544

Mailing address

2256 Park Centre Dr # 5-110
Westminster, CO 80234-5620
Phone (608) 445-7243

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

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1790452779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2256 PARK CENTRE DR # 5-110",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802345620",
            "telephone_number": "608-445-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2833 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043544",
            "telephone_number": "303-449-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFISTER",
        "first_name": "JAYSON",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.