OBSTETRIX MEDICAL GROUP OF COLORADO, P.C. (NPI# 1568086890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568086890 |
| Entity Type | Organization |
| Organization Name | OBSTETRIX MEDICAL GROUP OF COLORADO, P.C. |
| Practice Address |
4700 Lady Moon Dr Fort Collins CO 80528-4426 |
| Mailing Address |
4722 N 24th St Ste 150 Phoenix AZ 85016-4860 |
| Practice Telephone | 9708214000 |
| Mailing Telephone | 8777374546 |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2020-06-02 |
| Authorized Official Name | DR. RICHARD P PORRECO (PRESIDENT) |
| Authorized Official Telephone | 9543840175 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 9000166171 | 05 |
| Other Name | Type Code |
|---|---|
| Rocky Mountain Pediatric Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460464 | Obstetrix Medical Group of Colorado, P.C. | Obstetrics & Gynecology | 1421 S Potomac St Ste 240, Aurora, CO 80012-4512 | 2020-06-04 |
| 1396369443 | Obstetrix Medical Group of Colorado, P.C. | Obstetrics & Gynecology | 80 Health Park Dr Ste 235, Louisville, CO 80027-9584 | 2020-06-04 |
| 1477177533 | Obstetrix Medical Group of Colorado, P.C. | Nurse Practitioner | 90 Health Park Dr Ste 390, Louisville, CO 80027-9742 | 2020-06-04 |
| 1053935270 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 10099 Ridgegate Pkwy Ste 300, Lone Tree, CO 80124-5534 | 2020-06-03 |
| 1851915227 | Obstetrix Medical Group of Colorado, P.C. | Obstetrics & Gynecology | 1830 Blake Ave Ste 208, Glenwood Springs, CO 81601-4261 | 2020-06-02 |
| 1750905121 | Obstetrix Medical Group of Colorado, P.C. | Obstetrics & Gynecology | 4500 E 9th Ave Ste 210, Denver, CO 80220-3921 | 2020-06-02 |
| 1275157661 | Obstetrix Medical Group of Colorado, P.C. | Obstetrics & Gynecology | 499 E Hampden Ave Ste 210, Englewood, CO 80113-2792 | 2020-06-02 |
| 1386268753 | Obstetrix Medical Group of Colorado, P.C. | Obstetrics & Gynecology | 1808 Boise Ave Ste 120pod1, Loveland, CO 80538-5012 | 2020-06-02 |
| 1891319786 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 80 Health Park Dr Ste 235, Louisville, CO 80027-9584 | 2020-06-05 |
| 1659995603 | Obstetrix Medical Group of Colorado, P.C. | Obstetrics & Gynecology | 10101 Ridgegate Pkwy, Lone Tree, CO 80124-5522 | 2020-06-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | OBSTETRIX MEDICAL GROUP OF COLORADO, P.C. | 1301 Concord Terrace, Sunrise, FL 33323 |
| Street Address |
4700 LADY MOON DR |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80528-4426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659787554 | Banner Health | General Acute Care Hospital | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2014-07-11 |
| 1770192288 | Tracy J Hall | Registered Nurse | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2020-07-30 |
| 1639705999 | Michelle Powers | Occupational Therapist | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2020-03-19 |
| 1659904357 | Rocky Mountain State Anesthesia Providers | Anesthesiology | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2020-02-20 |
| 1912568866 | Stephanie Anne Martin | Nurse Practitioner | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2019-06-21 |
| 1881166593 | Noco Newco, LLC | Clinic/Center | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2018-12-19 |
| 1124532924 | Banner Health | Ambulance | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2017-12-01 |
| 1538688239 | Banner Fort Collins Medical Center | Clinical Medical Laboratory | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2017-09-13 |
| 1043673403 | Kymberlee Royals | Anesthesiology | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2016-04-03 |
| 1467812404 | Kristina Kinney | Nurse Practitioner | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2016-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518475391 | Corinna Kromer | Specialist | 4818 Snowdrift Circle, Fort Collins, CO 80528 | 2018-01-16 |
| 1447793419 | Suites Fort Collins LLC | Skilled Nursing Facility | 4880 Ziegler Rd, Fort Collins, CO 80528 | 2016-11-23 |
| 1790231413 | Pineridge Healthcare, Inc. | Skilled Nursing Facility | 4880 Ziegler Road, Fort Collins, CO 80528 | 2016-09-01 |
| 1750647244 | Annika Svea Kamberelis | Physician Assistant | 2121 E Harmony Rd Unit 300, Fort Collins, CO 80528 | 2012-04-09 |
| 1831481944 | Natasha E. Walter-fisk | Counselor | 5225 White Willow Dr. M220, Fort Collins, CO 80528 | 2011-05-07 |
| 1629216627 | Augusto Miravalle | Psychiatry & Neurology | 2121 E. Harmony Road, Suite 180, Ft Collins, CO 80528 | 2009-01-29 |
| 1114100252 | Alicia R. Young | Psychologist | 8010 S Country Road 5, Suite 201, Windsor, CO 80528 | 2007-12-12 |
| 1346446903 | Jill Marie Olson | Psychiatry & Neurology | 2121 E. Harmony Road #180, Fort Collins, CO 80528 | 2007-06-21 |
| 1437368578 | Shelley M Oliver | Orthopaedic Surgery | 2121 E. Harmony Rd. Ste 290, Fort Collins, CO 80528 | 2007-05-22 |
| 1174748008 | Light of The Rockies Christian Counseling Center | Clinic/Center | 5236 Strauss Cabin Rd, Fort Collins, CO 80528 | 2007-04-16 |
| Find all providers in zip 80528 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935270 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 10099 Ridgegate Pkwy Ste 300, Lone Tree, CO 80124-5534 | 2020-06-03 |
| 1215125208 | Abhay Ashok Divekar | Pediatrics | 2001 N High St, Denver, CO 80205-5555 | 2007-10-04 |
| 1982794798 | Pediatric Cardiology Associates | Pediatrics | 1725 E Boulder Street, Suite 202, Colorado Springs, CO 80909 | 2006-10-13 |
| 1700824430 | Michael Darby Pettersen | Pediatrics | 2055 N High St, Suite 255, Denver, CO 80205-5503 | 2006-06-03 |
| 1881292274 | Yampa Valley Medical Center | Pediatrics | 940 Central Park Dr Ste 190, Steamboat Springs, CO 80487-8853 | 2020-10-16 |
| 1891319786 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 80 Health Park Dr Ste 235, Louisville, CO 80027-9584 | 2020-06-05 |
| 1023632916 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 1906 Blake Ave, Glenwood Springs, CO 81601-4227 | 2020-06-05 |
| 1083238034 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 377 Sylvan Lake Rd, Eagle, CO 81631-5242 | 2020-06-05 |
| 1043834096 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 10101 Ridgegate Pkwy, Lone Tree, CO 80124-5522 | 2020-06-05 |
| 1295359180 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 1024 Central Park Dr, Steamboat Springs, CO 80487-8813 | 2020-06-05 |
| Find all providers with the same taxonomy | ||||
| City | FORT COLLINS |
| Zip Code | 80528 |
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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.