Jennifer Jean Poulson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0998003-NP Issued in CO

Practice address

8010 S County Road 5 Unit 205
Fort Collins, CO 80528-9004

Phone

(888) 777-2718

NPI assigned

Oct 19, 2022

Last updated

Oct 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Jean Shreeve Former name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Origin Healthcare PC

  • Internal Medicine Physician
  • Windsor, CO
  • NPI 1770256737
  Medicare reassignment
• Origin Healthcare, LLC

  • Hospitalist Physician
  • Fort Collins, CO
  • NPI 1982206173
  NPD (past)

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1821714916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 LAKE HOLLOW RD",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805138412",
            "telephone_number": "303-565-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 S COUNTY ROAD 5 UNIT 205",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289004",
            "telephone_number": "888-777-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSON",
        "first_name": "JENNIFER",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0998003-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SHREEVE",
            "middle_name": "JEAN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Poudre Valley Periodontics & Dental Implants
• Poudre Valley Radiation Oncology LLC
• Elaine Marie Poulin, PHD
• Matthew David Pouliot, D.O.
• Anne Karen Poulson, MA, MED, LPC, NCC
• Kayla Elizabeth Poulson, MA, LPC
• David B Powell, MD
• David L Powell, MAT-CERT. SPECIALIST
• Jamie Powell, LCSW, LAC, MSW, ADS
• Kristen Powell

• Family Nurse Practitioner in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.