Individual provider Active NPI

Jean C. Kottke, CANP

  • Adult Health Nurse Practitioner
  • Denver, CO
National Provider Identifier
1952573537
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
60316 Issued in CO
Practice address
1055 Clermont St
Denver, CO 80220-3808
Phone
(303) 399-8020
Fax
(303) 393-5064
NPI assigned
Mar 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 60316 CO Primary

Addresses

Primary practice location

1055 Clermont St
Denver, CO 80220-3808

Mailing address

1055 Clermont St
Denver, CO 80220-3808
Phone (303) 399-8020

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)
Not enrolled
Credentials
Certified Adult Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
60316COMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1952573537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 CLERMONT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203808",
            "telephone_number": "303-399-8020",
            "fax_number": "303-393-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 CLERMONT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203808",
            "telephone_number": "303-399-8020",
            "fax_number": "303-393-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTTKE",
        "first_name": "JEAN",
        "middle_name": "C.",
        "credential": "CANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "60316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.