Beverly Elaine Donnelley, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

24489 Issued in CO

Practice address

1107 S Lemay Ave
Suite 300
Fort Collins, CO 80524-3957

Phone

(970) 493-7442

Fax

(970) 493-2990

NPI assigned

Feb 14, 2006

Last updated

May 5, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Beverly Jessup Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241481600000",
    "number": "1053385492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 S LEMAY AVE",
            "address_2": "SUITE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243957",
            "telephone_number": "970-493-7442",
            "fax_number": "970-493-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S LEMAY AVE",
            "address_2": "SUITE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243957",
            "telephone_number": "970-493-7442",
            "fax_number": "970-493-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLEY",
        "first_name": "BEVERLY",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2009-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CO",
            "license": "24489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "84059624501",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "DO84038",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01244896",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "JESSUP",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicole Marie Dollard, LPCC
• Lidia Dominguez-Valles
• Dominic Smith
• Heather Domko, MSW, LSW
• Elizabeth Anne Donelson
• Angel Gabriel Dono, MD
• Joann Dooley, D.C.
• Adrienne Doran-Stout
• Amy Jennifer Doran, RN, MPH
• Dorinna S Ruh, LCSW, LLC

• Gynecology Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Gynecology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; 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.