Individual provider Active NPI

Stacy L Jessen, FNP

  • Family Nurse Practitioner
  • Golden, CO
National Provider Identifier
1831387968
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0000604 Issued in CO
Practice address
5920 McIntyre St
Golden, CO 80403-7445
Phone
(720) 434-4876
Fax
(303) 225-4246
NPI assigned
Oct 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0000604 CO Primary

Addresses

Primary practice location

5920 McIntyre St
Golden, CO 80403-7445

Mailing address

5920 McIntyre St
Golden, CO 80403-7445
Phone (720) 434-4876

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
I20161021000552 CO Practitioner - Nurse Practitioner 3274613732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadows Family Medical Center IncGroup PAC ID 0446151617, 64 clinicians

Practice addresses (Care Compare)

999 17TH St
Suite 500
Denver, CO 80202-2728
Phone (720) 355-0539

Hospital & facility affiliations

  • Optimal Home Care Loveland Home health agency, Loveland, CO, CCN 067546

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0000604COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meadows Family Medical Center Inc CurrentSince Nov 9, 2017 Accepting new patients
Heart Clinic of Austin, PA Past Accepting new patients

Locations

999 17th St
Ste 500
Denver, CO 80202
Phone (720) 355-0539

5920 McIntyre St
Golden, CO 80403
Phone (303) 949-1250

11166 Huron St
Ste 27
Northglenn, CO 80234
Phone (303) 425-5536

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1831387968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 MCINTYRE ST",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804037445",
            "telephone_number": "720-434-4876",
            "fax_number": "303-225-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 MCINTYRE ST",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804037445",
            "telephone_number": "720-434-4876",
            "fax_number": "303-225-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEN",
        "first_name": "STACY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0000604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

Verify at the official NPI Registry.