NPIMap

Individual provider Active NPI

Jolene Phelps, FNP-BC

  • Nurse Practitioner
  • Greeley, CO
National Provider Identifier
1972176410
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0102260 Issued in CO
Practice address
2010 16TH St Ste a
Greeley, CO 80631-5188
Phone
(970) 810-2026
Fax
(970) 810-2028
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 0102260 CO Primary

Addresses

Primary practice location

2010 16TH St Ste a
Greeley, CO 80631-5188

Mailing address

2010 16TH St Ste a
Greeley, CO 80631-5188
Phone (970) 571-1307

Other identifiers 1

IdentifierTypeStateIssuer
2050216MedicaidWA

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
I20240810000255 CO Practitioner - Nurse Practitioner 3678977618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2010 16TH St
Suite a
Greeley, CO 80631-5188
Phone (970) 810-4475

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102260COMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Aug 1, 2024 Accepting new patients
Banner Health Physicians Colorado LLC Single Specialty CurrentSince Aug 1, 2024 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

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

2010 16th St
Ste A
Greeley, CO 80631
Phone (970) 378-4475

1900 Boise Ave
Ste 220
Loveland, CO 80538
Phone (970) 203-2120

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1972176410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 16TH ST STE A",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315188",
            "telephone_number": "970-571-1307",
            "fax_number": "970-810-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 16TH ST STE A",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315188",
            "telephone_number": "970-810-2026",
            "fax_number": "970-810-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "JOLENE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "0102260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2050216",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.