NPIMap

Individual provider Active NPI

Mary Ryan Scott, APN

  • Family Nurse Practitioner
  • Superior, CO
National Provider Identifier
1942331582
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3912 Issued in CO
Practice address
3 Superior Dr Ste 100B
Superior, CO 80027-8653
Phone
(303) 415-8940
Fax
(303) 425-9259
NPI assigned
Mar 7, 2007
Last updated
Sep 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R33217 NM
Family Nurse Practitioner 363LF0000X 3912 CO Primary

Addresses

Primary practice location

3 Superior Dr Ste 100B
Superior, CO 80027-8653

Mailing address

2820 Table Mesa Dr
Boulder, CO 80305-5749
Phone (505) 670-5050

Other practice location 1

101 Erie Pkwy Ste 101
Erie, CO 80516-4071
Phone (303) 415-8800

Other practice location 2

2045 Franklin St
Denver, CO 80205-5437
Phone (505) 670-5050

Other identifiers 1

IdentifierTypeStateIssuer
00077947MedicaidNM

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
I20090204000590 CO Practitioner - Nurse Practitioner 1355405432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

6685 Gunpark Dr
Suite 102
Boulder, CO 80301-3343
Phone (303) 415-5199

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3912COMDFamily Nurse Practitioner
R33217NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LG Behavioral Health of Colorado LLC CurrentSince Nov 9, 2023 Accepting new patients
Boulder Community Health CurrentSince Feb 1, 2018 Accepting new patients
Boulder Community Health CurrentSince Feb 1, 2018 Accepting new patients
Boulder Community Health Current Accepting new patients

Locations

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

6685 Gunpark Dr
Ste 102
Boulder, CO 80301
Phone (303) 415-5199

2095 W 6th Ave
Ste 106
Broomfield, CO 80020
Phone (303) 448-9713

101 Erie Pkwy
Ste 101
Erie, CO 80516
Phone (303) 415-5810

6950 E Belleview Ave
Ste 300
Greenwood Village, CO 80111
Phone (303) 468-8018

3 Superior Dr
Ste 100B
Superior, CO 80027
Phone (303) 415-8940

Organizations & group practices 4

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1942331582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 TABLE MESA DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055749",
            "telephone_number": "505-670-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SUPERIOR DR STE 100B",
            "city": "SUPERIOR",
            "state": "CO",
            "postal_code": "800278653",
            "telephone_number": "303-415-8940",
            "fax_number": "303-425-9259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Erie Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "CO",
            "postal_code": "805164071",
            "country_code": "US",
            "telephone_number": "303-415-8800",
            "fax_number": "303-415-8801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2045 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802055437",
            "country_code": "US",
            "telephone_number": "505-670-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "MARY",
        "middle_name": "RYAN",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R33217",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "3912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00077947",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, CO

Sources for this page

Verify at the official NPI Registry.