Individual provider Active NPI

Jake Alexander Verduzco

  • Counselor
  • Denver, CO
National Provider Identifier
1821770108
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
9123 E Mississippi Ave Apt 8-104
Denver, CO 80247-6876
Phone
(612) 735-4395
NPI assigned
Aug 4, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

9123 E Mississippi Ave Apt 8-104
Denver, CO 80247-6876

Mailing address

9123 E Mississippi Ave Apt 8-104
Denver, CO 80247-6876
Phone (612) 735-4395

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": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1821770108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9123 E MISSISSIPPI AVE APT 8-104",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802476876",
            "telephone_number": "612-735-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 E MISSISSIPPI AVE APT 8-104",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802476876",
            "telephone_number": "612-735-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDUZCO",
        "first_name": "JAKE",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-04",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.