Individual provider Active NPI

Katie Ann Wenzel, FNP-C

  • Family Nurse Practitioner
  • Longmont, CO
National Provider Identifier
1801296348
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0991914-NP Issued in CO
Practice address
2101 Main St
Longmont, CO 80501-1406
Phone
(720) 745-8030
Fax
(720) 745-8031
NPI assigned
Sep 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.0175182 CO
Nurse Practitioner 363L00000X APN.0991914-NP CO
Family Nurse Practitioner 363LF0000X 34182.1340 WY
Family Nurse Practitioner 363LF0000X APN.0991914-NP CO Primary

Addresses

Primary practice location

2101 Main St
Longmont, CO 80501-1406

Mailing address

2101 Main St
Longmont, CO 80501-1406
Phone (720) 745-8030

Other practice location 1

1025 Pennock Pl
suite 121
Fort Collins, CO 80524-3257
Phone (970) 495-8800

Other identifiers 1

IdentifierTypeStateIssuer
01730061MedicaidCO

Other names 1

  • Mrs. Katie Wenzel Vecchio Former name

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
I20160309000084 CO Practitioner - Nurse Practitioner 3678792348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
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)

2101 Main St
Longmont, CO 80501-1406
Phone (720) 745-8020

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.0175182COMDRegistered Nurse
34182.1340WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 19, 2021 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 19, 2021 Accepting new patients
Poudre Valley Health Care, Inc CurrentSince Nov 22, 2015 Accepting new patients
Poudre Valley Health Care Inc CurrentSince Nov 22, 2015 Accepting new patients
Poudre Valley Health Care Inc. Current Accepting new patients

Locations

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

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

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

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

1025 Pennock Pl
Ste 114
Fort Collins, CO 80524
Phone (970) 495-8800

1025 Pennock Pl
Ste 121
Fort Collins, CO 80524
Phone (970) 495-8800

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

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

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

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

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

3850 Grant Ave
Ste 200
Loveland, CO 80538
Phone (970) 624-5170

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 5

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1801296348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011406",
            "telephone_number": "720-745-8030",
            "fax_number": "720-745-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011406",
            "telephone_number": "720-745-8030",
            "fax_number": "720-745-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Pennock Pl",
            "address_2": "suite 121",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805243257",
            "country_code": "US",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "KATIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0175182",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0991914-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "34182.1340",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0991914-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01730061",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "VECCHIO",
            "middle_name": "WENZEL",
            "prefix": "MRS.",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.