Individual provider Active NPI

Jessica Mae Light, APN, AGNP-BC

  • Primary Care Nurse Practitioner
  • Parker, CO
National Provider Identifier
1932734878
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APN.0995140-NP Issued in CO
Practice address
12230 Lioness Way
Parker, CO 80134-5603
Phone
(720) 644-9355
NPI assigned
Mar 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APN.0995140-NP CO
Primary Care Nurse Practitioner 363LP2300X APN.0995140-NP CO Primary

Addresses

Primary practice location

12230 Lioness Way
Parker, CO 80134-5603

Mailing address

12230 Lioness Way
Parker, CO 80134-5603
Phone (720) 644-9355

Other practice location 1

5023 W 120th Ave # 312
Broomfield, CO 80020-5606
Phone (720) 644-9355

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200504002615 CO Practitioner - Nurse Practitioner 5092146266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Consultants PLLCGroup PAC ID 0547589517, 78 clinicians

Practice addresses (Care Compare)

12230 Lioness Way
Parker, CO 80134-5603
Phone (720) 644-9355

Merit-based Incentive Payment System (MIPS)

Final score
76.42 of 100Reported as apm
Quality
55.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0995140-NPCOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnectmd Colorado Inc. Family Medicine CurrentSince Feb 1, 2025 Accepting new patients
Summit Medical Consultants PLLC CurrentSince May 1, 2020 Accepting new patients
Summit Medical Consultants Aco Prof LLC CurrentSince Aug 26, 2023 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

6870 W 52nd Ave
Ste 102
Arvada, CO 80002
Phone (303) 534-0391

5023 W 120th Ave
Broomfield, CO 80020
Phone (303) 644-9355

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

9250 E Costilla Ave
Ste 540
Greenwood Village, CO 80112

12230 Lioness Way
Parker, CO 80134
Phone (720) 214-7777

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1932734878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12230 LIONESS WAY",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801345603",
            "telephone_number": "720-644-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 LIONESS WAY",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801345603",
            "telephone_number": "720-644-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5023 W 120th Ave # 312",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800205606",
            "country_code": "US",
            "telephone_number": "720-644-9355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "credential": "APN, AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0995140-NP",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CO",
            "license": "APN.0995140-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.