MEDICARE: JILL W. VESSEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	202D00000X	Integrative Medicine Physician	DR.0044692	CO
2	207P00000X	Emergency Medicine Physician	DR.0044692	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00411372	OTHER	WY	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	314442	OTHER	WY	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649204934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL W. VESSEY

Provider Business Mailing Address
First Line	:	4190 E WOODMEN RD STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-8075
Country	:	US
Telephone Number	:	719-632-4455
Fax Number	:

Provider Business Practice Location Address
First Line	:	4190 E WOODMEN RD STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-8075
Country	:	US
Telephone Number	:	719-632-4455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	10/28/2025

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Directions to “ JILL W. VESSEY ” Practice Location

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