Lifestyle Medicine at Miramont, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LIFESTYLE MEDICINE AT MIRAMONT, LLC

Practice address

2211 S College Ave
Unit 300
Fort Collins, CO 80525-1489

Phone

(970) 237-6339

Fax

(970) 482-2091

NPI assigned

Dec 17, 2010

Organization subpart

Yes

Parent organization

URGENT CARE AT MIRAMONT, LLCAs reported in NPPES

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

Authorized official

Name

Ms. Lisa Austin

Title

Vice President of Operations

Phone

(970) 237-6339

Specialties & licenses 1

Addresses

Part of

Urgent Care at Miramont LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Urgent Care at Miramont, LLC

  • Urgent Care Clinic/Center
  • Fort Collins, CO
  • NPI 1558671800
  NPPES parent name

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1043513724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 S COLLEGE AVE",
            "address_2": "UNIT 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251489",
            "telephone_number": "970-237-6339",
            "fax_number": "970-482-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 S COLLEGE AVE",
            "address_2": "UNIT 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251489",
            "telephone_number": "970-237-6339",
            "fax_number": "970-482-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE MEDICINE AT MIRAMONT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "URGENT CARE AT MIRAMONT, LLC",
        "enumeration_date": "2010-12-17",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "970-237-6339",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.