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JESSICA SUSANA NEDOM NP NPI 1184936627


NPI Information

NPI: 1184936627
Provider Name: JESSICA SUSANA NEDOM, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: BANNER HEALTH PHYSICIANS COLORADO LLC

PECOS Registration: Yes

Address:
2930 11TH AVE
EVANS, CO
ZIP 80620
Phone: (970) 353-9403
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Jessica Susana Nedom, NP is a family nurse practitioner in Evans, CO with 14 years of experience. Jessica Susana Nedom, NP NPI is 1184936627. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2930 11TH AVE
EVANS, CO
ZIP 80620-011
Phone: (970) 353-9403
Fax: (970) 353-9906

The NPI 1184936627 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Automated urinalysis test (HCPCS:81003)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Pneumococcal vaccine for injection into muscle (HCPCS:90670)

The enumeration date for this NPI number is 7/13/2010 and was last updated on 12/24/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1163W00000XRegistered Nurse176219COLORADONo
2363LF0000XNurse PractitionerFamily10334COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1COA105349MEDICARE OSCAR/CERTIFICATION
237179870MEDICAIDCOLORADO
3COA105349MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.