Jack Geddes

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

ADDC.0000392 Issued in CO

Practice address

3000 S College Ave Unit 202
Fort Collins, CO 80525-2558

Phone

(970) 221-4057

NPI assigned

Feb 26, 2022

Last updated

Aug 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1645833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1871249045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 S COLLEGE AVE UNIT 202",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252558",
            "telephone_number": "970-221-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S COLLEGE AVE UNIT 202",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252558",
            "telephone_number": "970-221-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDDES",
        "first_name": "JACK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-26",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "ADDC.0000392",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ADDC.0000392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Dianne Gawryletz, DO
• Joshua Jeremiah Gaylord
• Karissa Caylene Gayosso, AGACNP-BC
• Amy Marie Gebers, CST, CFA
• Terry Lee Gebhardt, PT, MPT, DPT
• Jessica Gefre, CNM
• John Raymond Geis, MD
• Linda Geis, M.D.
• Lisa Ann Geisterfer, LPC
• Samuel Hayes Gelber, MFTC

• Addiction (Substance Use Disorder) Counselor in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.