NPIMap

Individual provider Active NPI

Barbara A Pivonka, FNP

  • Nurse Practitioner
  • Fort Lupton, CO
National Provider Identifier
1942204698
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0002434-NP Issued in CO
Practice address
1115 2ND St
Fort Lupton, CO 80621-1745
Phone
(303) 857-2771
Fax
(720) 322-9434
NPI assigned
Jun 10, 2005
Last updated
Jun 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0002434-NP CO Primary

Addresses

Primary practice location

1115 2ND St
Fort Lupton, CO 80621-1745

Mailing address

203 S Rollie Ave
Billing Dept - Credentialist
Fort Lupton, CO 80621-1508
Phone (303) 286-4560

Other identifiers 1

IdentifierTypeStateIssuer
07882874MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080111000165 CO Practitioner - Nurse Practitioner 1951482371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 70TH Ave
Suite 200
Greeley, CO 80634-4613
Phone (970) 810-3550

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Aug 1, 2019 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Aug 1, 2019 Accepting new patients
Colorado Endoscopy Services, Inc Past Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients
James a Miller MD PC Past Accepting new patients

Locations

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

2001 70th Ave
Ste 200
Greeley, CO 80634
Phone (970) 313-0027

Organizations & group practices 5

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1942204698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "address_2": "BILLING DEPT - CREDENTIALIST",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-286-4560",
            "fax_number": "303-286-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 2ND ST",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211745",
            "telephone_number": "303-857-2771",
            "fax_number": "720-322-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIVONKA",
        "first_name": "BARBARA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0002434-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07882874",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lupton, CO

Sources for this page

Verify at the official NPI Registry.