Individual provider Active NPI

Julia Graham Mesnikoff, MSN, FNP

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1851363766
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
168456 Issued in CO
Practice address
1625 Medical Center PT
Suite 190
Colorado Springs, CO 80907-8731
Phone
(719) 955-6000
Fax
(719) 955-9595
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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 168456 CO Primary

Addresses

Primary practice location

1625 Medical Center PT
Suite 190
Colorado Springs, CO 80907-8731

Mailing address

1625 Medical Center PT
Suite 190
Colorado Springs, CO 80907-8731
Phone (719) 955-6000

Other identifiers 1

IdentifierTypeStateIssuer
97830089MedicaidCO

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)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
168456COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Medical Foundation, Inc. Past Accepting new patients
William Storms Allergy Clinic PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1851363766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 MEDICAL CENTER PT",
            "address_2": "SUITE 190",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078731",
            "telephone_number": "719-955-6000",
            "fax_number": "719-955-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 MEDICAL CENTER PT",
            "address_2": "SUITE 190",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078731",
            "telephone_number": "719-955-6000",
            "fax_number": "719-955-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESNIKOFF",
        "first_name": "JULIA",
        "middle_name": "GRAHAM",
        "name_prefix": "Ms.",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "168456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97830089",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.