NPIMap

Organization Active NPI

Children's Hospital Colorado

Doing business as Children's Colorado Regional Outreach Clinic - Fort Collins - FCYC

  • Multi-Specialty Clinic/Center
  • Fort Collins, CO
National Provider Identifier
1003496662
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CHILDREN'S HOSPITAL COLORADO
Doing business as
Children's Colorado Regional Outreach Clinic - Fort Collins - FCYC
Practice address
1214 Oak Park Dr
Fort Collins, CO 80525-7302
Phone
(970) 267-9510
NPI assigned
Apr 8, 2021
Last updated
Apr 8, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILDREN'S HOSPITAL COLORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Linda Michael
Title
VP, Chief Compliance Officer
Phone
(720) 777-6537

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1214 Oak Park Dr
Fort Collins, CO 80525-7302

Mailing address

13123 E 16TH Ave # B095
Aurora, CO 80045-7106
Phone (720) 777-1234

Other names 1

  • Children's Colorado Regional Outreach Clinic - Fort Collins - FCYC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151006000071 CO Part B Supplier - Clinic/Group Practice 3274447925 Receives reassigned benefits from 1 practitioner
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aurora, CO; Colorado Springs, CO

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
The Children's Hospital Aurora Co

Locations

13123 E 16th Ave
Ste B10
Aurora, CO 80045

469 State Highway 7
Broomfield, CO 80023
Phone (720) 478-5000

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1003496662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE # B095",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234",
            "fax_number": "720-777-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 OAK PARK DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805257302",
            "telephone_number": "970-267-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL COLORADO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S HOSPITAL COLORADO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "VP, CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "720-777-6537"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Colorado Regional Outreach Clinic - Fort Collins - FCYC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.