NPIMap

Individual provider Active NPI

Jonathan Paul Nienhouse, FNP

  • Family Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1841388402
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0003741-NP Issued in CO
Practice address
6685 Gunpark Dr
Suite 102
Boulder, CO 80301-3388
Phone
(303) 415-5199
Fax
(303) 415-5198
NPI assigned
Oct 10, 2006
Last updated
Nov 9, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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.0003741-NP CO Primary

Addresses

Primary practice location

6685 Gunpark Dr
Suite 102
Boulder, CO 80301-3388

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 415-5199

Other identifiers 1

IdentifierTypeStateIssuer
24231860MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060118000567 CO Practitioner - Nurse Practitioner 1557385424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

101 Erie Pkwy
Suite 101
Erie, CO 80516-4071
Phone (303) 415-5810

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3741COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Aug 30, 2005 Accepting new patients
Boulder Community Health CurrentSince Aug 30, 2005 Accepting new patients
Boulder Community Health Current Accepting new patients
Clinica Campesina Family Health Services Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

1001 North St
#B
Boulder, CO 80304
Phone (303) 442-8840

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

311 Mapleton Ave
Boulder, CO 80304
Phone (303) 544-5700

4801 Riverbend Rd
Ste 300
Boulder, CO 80301
Phone (303) 415-8621

5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770

6685 Gunpark Dr
Ste 102
Boulder, CO 80301
Phone (303) 415-5199

101 Erie Pkwy
Ste 101
Erie, CO 80516
Phone (303) 415-5810

Interoperability endpoints

  • Direct secure messaging: nienhou.j@bch.gwaydirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1841388402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-5199",
            "fax_number": "303-415-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6685 GUNPARK DR",
            "address_2": "SUITE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013388",
            "telephone_number": "303-415-5199",
            "fax_number": "303-415-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIENHOUSE",
        "first_name": "JONATHAN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0003741-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24231860",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.