COLORADO MEDICAL GROUP, PLLC (NPI# 1467069120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467069120 |
| Entity Type | Organization |
| Organization Name | COLORADO MEDICAL GROUP, PLLC |
| Other Organization Name | UNITED VEIN CENTERS OF FORT COLLINS, CO |
| Practice Address |
3665 John F Kennedy Pkwy Ste 200 Fort Collins CO 80525-3152 |
| Mailing Address |
3810 Northdale Blvd Ste 150 Tampa FL 33624-1871 |
| Practice Telephone | 8009916117 |
| Practice Fax Number | 8888128191 |
| Mailing Telephone | 8139611331 |
| Mailing Fax Number | 8888508316 |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | LORI HEIN (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 8133799829 |
| Is Organization Subpart | Y |
| Parent Organization Name | COLORADO MEDICAL GROUP, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| United Vein Centers of Fort Collins, CO | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928234 | Colorado Medical Group, Pllc | Surgery | 6979 S Holly Cir Ste 125, Centennial, CO 80112-6267 | 2020-09-30 |
| 1730796400 | Colorado Medical Group, Pllc | Surgery | 255 Union Blvd Ste 300, Lakewood, CO 80228-1859 | 2020-09-28 |
| 1811504582 | Colorado Medical Group, Pllc | Surgery | 1044 S 88th St Ste 105, Louisville, CO 80027-9418 | 2020-09-28 |
| 1356714638 | Colorado Medical Group, Pllc | Surgery | 6979 S Holly Cir Ste 125, Centennial, CO 80112-6267 | 2015-11-09 |
| Street Address |
3665 JOHN F KENNEDY PKWY STE 200 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80525-3152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950299 | Kelly Westbrook Schmalstich | Clinical Nurse Specialist | 2020 Blue Yonder Way, Fort Collins, CO 80525 | 2020-07-27 |
| 1912522376 | Tender Gifts Midwifery and Birth Center | Clinical Nurse Specialist | 1817 Jessup Dr Farms, Fort Collins, CO 80525 | 2020-06-11 |
| 1114566015 | Andrea Nicole Brogdon | Acupuncturist | 2501 S. College Ave, Fort Collins, CO 80525 | 2019-12-26 |
| 1013553593 | Kids Overcoming, LLC | Home Health | 1330 Oakridge Drive Suite 105, Fort Collins, CO 80525 | 2019-11-20 |
| 1568019966 | Julia Heithoff | Behavioral Analyst | 1100 Haxton Dr #115, Fort Collins, CO 80525 | 2019-08-20 |
| 1144875246 | Harmony Smiles Dentistry, LLP | Dentist | 356 E Harmony Rd., #6-a, Fort Collins, CO 80525 | 2019-08-06 |
| 1841774502 | Shannon L Harris | Social Worker | 305 Carpenter Road, Fort Collins, CO 80525 | 2018-09-19 |
| 1306332101 | Joshua Evans Brooks | Optometrist | 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 | 2018-07-03 |
| 1285120212 | Danae Fuqua | Physical Medicine & Rehabilitation | Covell Care & Rehabilitation, 2350 Limon Dr., Fort Collins, CO 80525 | 2018-07-02 |
| 1528552890 | Megan E Locke | Audiologist | 724 Whalers Way Bdg I, Suite 101, Fort Collins, CO 80525 | 2018-06-19 |
| Find all providers in zip 80525 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669588455 | The Vein and Laser Center of Northern Colorado, LLC | Surgery | 1915 Wilmington Dr, Fort Collins, CO 80528-6299 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831706506 | University Physicians, Incorporated | Surgery | 13100 E Colfax Ave Ste 70, Aurora, CO 80011-5517 | 2020-09-28 |
| 1376015297 | Molly Goldstein | Surgery | 1401 Court St, Pueblo, CO 81003-2715 | 2018-12-18 |
| 1437412723 | Junior Univers | Surgery | 2643 Patterson Rd Ste 401, Grand Junction, CO 81506-1937 | 2012-06-21 |
| 1275896508 | Dmitriy Rybitskiy | Surgery | 2222 N Nevada Ave Ste 5010, Colorado Springs, CO 80907-6865 | 2012-06-21 |
| 1518230333 | James Gilbert Chandler | Surgery | 3721 Mountain Laurel Pl, Boulder, CO 80304-0798 | 2012-02-10 |
| 1982982567 | Benson M Powell II | Surgery | 2572 Silver Oak Ct, Grand Junction, CO 81505-1091 | 2011-07-29 |
| 1205078912 | Rafael Demarchi Malgor | Surgery | 12631 E 17th Ave # Msc312, Aurora, CO 80045-2527 | 2009-03-26 |
| 1770610735 | Thomas F Rehring | Surgery | 2045 N Franklin St Fl 3, Denver, CO 80205-5437 | 2007-02-27 |
| 1770624298 | Charles O Brantigan Md | Surgery | 2253 Downing St, Denver, CO 80205-5234 | 2007-02-09 |
| 1588717656 | Cass William Conaway | Surgery | 721 19th St, Denver, CO 80202-2500 | 2007-01-19 |
| Find all providers with the same taxonomy | ||||
| City | FORT COLLINS |
| Zip Code | 80525 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.