Florissant Family Medicine, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

FLORISSANT FAMILY MEDICINE, LLC

Practice address

18100 County Rd 1
Florissant, CO 80816-9404

Phone

(719) 839-1923

Fax

(833) 539-1731

NPI assigned

Feb 3, 2020

Last updated

Sep 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deanna L McNulty, DNP, FNP-CNPI 1194208736

Title

Owner

Phone

(719) 839-1923

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26070/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deanna L McNulty, DNP

  • Family Nurse Practitioner
  • Florissant, CO
  • NPI 1194208736
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1871124248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "FLORISSANT",
            "state": "CO",
            "postal_code": "808160189",
            "telephone_number": "719-839-1923",
            "fax_number": "833-539-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18100 COUNTY RD 1",
            "city": "FLORISSANT",
            "state": "CO",
            "postal_code": "808169404",
            "telephone_number": "719-839-1923",
            "fax_number": "833-539-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORISSANT FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-839-1923",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Christine Bellinghausen, LPC, LIMHP LADC
• Hope Ann Clark, LCSW
• Community Smart, Inc.
• Community Smart, Inc.
• Monique Julia Ekker
• Four Mile Emergency Services, Inc.
• Patricia Ann Glatfelter, P.T.
• Megan Renee Grinnell
• Kerry Duane Hammack, LPC
• Rhonda Celeste Hern, LPC

• Primary Care Clinic/Center in Florissant, CO
• Providers in Florissant, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.