SearchColorado363A00000X

Jacob Shirley, PA

NPI 1992463970 · on the registry since 2021

Practice

Address
1925 Mountain View Ave Fl 3
Longmont, CO 80501
Phone
(720) 718-8240
Fax
(720) 718-0953
Organisation at this address
Longmont Clinic Lab
Poudre Valley Medical Group, Llc
University Physicians Incorporated
Inferred from a shared address, not stated in the registry.
Clinicians at this address
92

Registry record

Primary taxonomy
363A00000X
363A00000X
Also registered as
363A00000X
363A00000X
Licence states on file
WY, ID, CO
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-07-23

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado