Jacqueline L House, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3519 Richmond Dr
Fort Collins, CO 80526-5995

Phone

(970) 204-0300

NPI assigned

Dec 18, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• VMD Primary Providers Colorado, Inc

  • Primary Care Clinic/Center
  • Fort Collins, CO
  • NPI 1275646614

  CO

  Medicare reassignment

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1922429901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 RICHMOND DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265995",
            "telephone_number": "970-204-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 RICHMOND DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265995",
            "telephone_number": "970-204-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSE",
        "first_name": "JACQUELINE",
        "middle_name": "L",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaden Amanda Houck, FNP-C
• Jane Houck, CMT
• Nancy Hough, LPC
• Diana Maria Houghton, LPC.0019337
• Michael J Houghton, MD
• Marta Kendall House
• Savannah House
• Housing Catalyst
• Housing Catalyst
• Housing Catalyst

• All providers in Fort Collins, CO
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.