Individual provider Active NPI

Jeremy Thomas Sharp, PH.D.

  • Counseling Psychologist
  • Fort Collins, CO
National Provider Identifier
1821323676
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
3349 Issued in CO
Practice address
3500 John F Kennedy Pkwy
Ste 200
Fort Collins, CO 80525-2635
Phone
(970) 889-8204
Fax
(888) 494-3756
NPI assigned
Oct 13, 2009
Last updated
May 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 3349 CO Primary

Addresses

Primary practice location

3500 John F Kennedy Pkwy
Ste 200
Fort Collins, CO 80525-2635

Mailing address

3500 John F Kennedy Pkwy
Ste 200
Fort Collins, CO 80525-2635
Phone (970) 420-7919

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100204000742 CO Practitioner - Clinical Psychologist 9638212269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3500 John F Kennedy Pkwy
Suite 200
Fort Collins, CO 80525-2635
Phone 9708898204510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3349COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jeremy T. Sharp, PH.D., LLC Current Accepting new patients

Locations

3500 John F Kennedy Pkwy
Ste 200
Fort Collins, CO 80525
Phone (970) 670-0586

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1821323676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 JOHN F KENNEDY PKWY",
            "address_2": "STE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252635",
            "telephone_number": "970-420-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 JOHN F KENNEDY PKWY",
            "address_2": "STE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252635",
            "telephone_number": "970-889-8204",
            "fax_number": "888-494-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "JEREMY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-13",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CO",
            "license": "3349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.