Jacob Bristow, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APN.0999823-NP Issued in CO

Practice address

4155 E Jewell Ave Ste 500
Denver, CO 80222-4509

Phone

(720) 310-2773

Fax

(833) 916-0976

NPI assigned

Mar 16, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.bristow.1@21279.direct.athenahealth.com

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.

• National Mental Health Management, LLC

  • Addiction Psychiatry Physician
  • Wheat Ridge, CO
  • NPI 1306472568
  NPD

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1801597844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 E JEWELL AVE STE 500",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802224509",
            "telephone_number": "720-310-2773",
            "fax_number": "833-916-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 E JEWELL AVE STE 500",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802224509",
            "telephone_number": "720-310-2773",
            "fax_number": "833-916-0976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Regis Blvd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802218926",
            "country_code": "US",
            "telephone_number": "800-388-2366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRISTOW",
        "first_name": "JACOB",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-16",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0999823-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Briscoe
• Tiara Briscoe, RN
• Amy Renee Brissette, LCSW
• Audrey Bristol, LCSW
• Erica Bristow
• Roberta Brito Hidalgo
• Britt Bay LLC
• Dale E Britt, RN, ND
• Sarah Grace Britt, LCSW
• Brian Ward Britton, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Denver, CO
• Providers in Denver, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.