NPIMap

Individual provider Active NPI

Sandra Elizabeth Henderson, M.D.

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1053360834
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41526 Issued in CO
Practice address
2025 Bighorn Rd
Fort Collins, CO 80525
Phone
(970) 229-9800
Fax
(970) 229-1421
NPI assigned
May 9, 2006
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41526 CO Primary

Addresses

Primary practice location

2025 Bighorn Rd
Fort Collins, CO 80525

Mailing address

1300 Riverside Ave Ste 102
Fort Collins, CO 80524-4353
Phone (970) 224-1670

Other identifiers 1

IdentifierTypeStateIssuer
56952562MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100423000331 CO Practitioner - Family Practice 5092842021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

151 W Lake St
Suite 1500
Fort Collins, CO 80524-4124
Phone (970) 297-6700

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4674 Snow Mesa Dr
Suite 200
Fort Collins, CO 80528-8614
Phone (970) 495-8450

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41526COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 7, 2025 Accepting new patients
VMD Primary Providers Colorado, Inc Family Medicine CurrentSince Sep 1, 2003 Accepting new patients
Associates in Family Medicine, P.C. Family Medicine PastSince Oct 2, 2022 Accepting new patients

Locations

1300 Riverside Ave
Ste 102
Fort Collins, CO 80524
Phone (970) 224-1670

151 W Lake St
Ste 1500
Fort Collins, CO 80524
Phone (970) 237-8200

2025 Bighorn Rd
Fort Collins, CO 80525
Phone (970) 229-9800

3519 Richmond Dr
Fort Collins, CO 80526
Phone (970) 204-0300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1053360834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 RIVERSIDE AVE STE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244353",
            "telephone_number": "970-224-1670",
            "fax_number": "970-495-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 BIGHORN RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80525",
            "telephone_number": "970-229-9800",
            "fax_number": "970-229-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "SANDRA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "41526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56952562",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.