Active NPI 1134098833 Individual Practitioner Male Practitioner

Ethan Doe

Registered Nurse - Case Management • Boulder, CO

Professional Overview & Biography Verified Profile Summary

Ethan Doe is a registered healthcare professional specializing in Registered Nurse - Case Management in Boulder, CO. Practice services are available at 3180 AIRPORT RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3180 Airport Rd

Boulder, CO 803012208

Telephone 3034471665

Associated Practice Facility / Clinic

🏢 Boulder County Public Health Facility NPI 1649560004

Specialty Benchmarks & Practice Insights

Comparative analytics for Registered Nurse - Case Management in Boulder, CO

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 10.2 Yrs

Regional Practice Density

4 Specialists

Practicing in Boulder, CO (186 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-10-31

Registered Nurse - Case Management Primary Specialty

NUCC Taxonomy Code: 163WC0400X

State License CO RN.1675791

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

14 Associated Practitioners

Vicky Peterson , LCSW

Social Worker - Clinical

NPI 1083744890

Licensed Clinical Social Worker

Andrew Bender

Counselor - Addiction (Substance Use Disorder)

NPI 1114896826

Tina Pernosky

Counselor - Mental Health

NPI 1316061252

Sara Andersen , MA

Counselor - Mental Health

NPI 1326250408

Master of Arts

Martha Rosner , MA, LPC

Counselor - Mental Health

NPI 1386777845

Master of Arts, Licensed Professional Counselor

Alexis Karris , MA

Psychologist - Cognitive & Behavioral

NPI 1518176163

Master of Arts

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active October 31, 2025

NPI status registered as active in NPPES database

📍

Updated Practice Location October 31, 2025

Registered at 3180 AIRPORT RD, BOULDER, CO 803012208 (Tel: 3034471665)

📍

Updated Business Mailing Address October 31, 2025

Registered at 11823 RIDGE PKWY APT 817, BROOMFIELD, CO 800215099 (Tel: 7089417406)

👤

Provider Name / Credentials Updated October 31, 2025

Recorded as ETHAN DOE

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 31, 2025

Registered Nurse (License #RN.1675791 in CO)

🟢

Initial NPI Registration & Enumeration October 31, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1134098833

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 31, 2025

Last Update: October 31, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

11823 Ridge Pkwy Apt 817

Broomfield, CO 800215099

Phone: 7089417406

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.