Active NPI
Jeanette Valentin, M.D.
- Internal Medicine Physician
- Colorado Springs, CO
National Provider Identifier
1952300485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DR-52212
- Practice address
- 1400 E Boulder St
Colorado Springs, CO 80909-5533 - Phone
- (719) 365-1292
- Fax
- (719) 365-6997
- NPI assigned
- Jul 18, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036100498 | IL | |
| Internal Medicine Physician | 207R00000X | DR-52212 | CO | Primary |
Addresses
Primary practice location
1400 E Boulder St
Colorado Springs, CO 80909-5533
Mailing address
8890 N. Union Blvd
Suite 160
Colorado Springs, CO 80920
Phone (719) 365-9950
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70234833 | Medicaid | CO | |
| 0361004981 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036100498 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Knox Clinic Corp | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Cottage Orthopedics and Podiatry
- Durable Medical Equipment & Medical Supplies
- Galesburg, IL
- NPI 1669947503
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384128000000",
"number": "1952300485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8890 N. UNION BLVD",
"address_2": "SUITE 160",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80920",
"telephone_number": "719-365-9950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E BOULDER ST",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809095533",
"telephone_number": "719-365-1292",
"fax_number": "719-365-6997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENTIN",
"first_name": "JEANETTE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-18",
"last_updated": "2013-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036100498",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "DR-52212",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "70234833",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0361004981",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.