Individual provider Active NPI

Christa Elizabeth Ambrose, DO

  • Family Medicine Physician
  • Boulder, CO
National Provider Identifier
1902912116
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0044807 Issued in CO
Practice address
2525 13TH St
Boulder, CO 80304-4104
Phone
(303) 449-6050
Fax
(720) 565-4132
NPI assigned
Aug 21, 2006
Last updated
May 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0044807 CO Primary

Addresses

Primary practice location

2525 13TH St
Boulder, CO 80304-4104

Mailing address

1735 S Public Rd Ste 203
Lafayette, CO 80026-7093
Phone (303) 665-3036

Other identifiers 1

IdentifierTypeStateIssuer
81625863MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christa.ambrose.p4@direct.clinicafamilyhealth.nextgenshare.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061221000223 CO Practitioner - Osteopathic Manipulative Medicine 8729095914 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DR.0044807COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Campesina Family Health Services Current Accepting new patients
Clinica Campesina Family Health Services CurrentSince Jul 1, 2007 Accepting new patients
Clinica Campesina Family Health Services Past Accepting new patients

Locations

2525 13th St
Boulder, CO 80304
Phone (303) 449-6050

1345 Plaza Ct N
Ste 1A
Lafayette, CO 80026
Phone (303) 665-2962

1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061

1735 S Public Rd
Ste 203
Lafayette, CO 80026

Interoperability endpoints

  • Direct secure messaging: christa.ambrose.p4@direct.clinicafamilyhealth.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1902912116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 S PUBLIC RD STE 203",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267093",
            "telephone_number": "303-665-3036",
            "fax_number": "303-665-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 13TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044104",
            "telephone_number": "303-449-6050",
            "fax_number": "720-565-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "CHRISTA",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0044807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81625863",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christa.ambrose.p4@direct.clinicafamilyhealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGen EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "2525 13th St",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803044104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.