NPIMap

Individual provider Active NPI

James D Hendrick, MD

  • Obesity Medicine (Internal Medicine) Physician
  • Fort Collins, CO
National Provider Identifier
1073540571
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
License
37885 Issued in CO
Practice address
1939 Wilmington Dr
Suite 102
Fort Collins, CO 80528-6404
Phone
(970) 980-6024
Fax
(877) 489-6002
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37885 CO
Obesity Medicine (Internal Medicine) Physician 207RB0002X 37885 CO Primary

Addresses

Primary practice location

1939 Wilmington Dr
Suite 102
Fort Collins, CO 80528-6404

Mailing address

1939 Wilmington Dr
Suite 102
Fort Collins, CO 80528-6404
Phone (970) 980-6024

Other identifiers 3

IdentifierTypeStateIssuer
32801718MedicaidCO
636745OtherCOBCBS
117632300MedicaidWY

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
I20041221000128 CO Practitioner - Internal Medicine 4385602549 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1939 Wilmington Dr
Unit 102
Fort Collins, CO 80528-6104
Phone (970) 980-6024

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37885COMDObesity Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bariatric and Lifestyle Medicine LLC Obesity Medicine CurrentSince Mar 15, 2011 Accepting new patients
Poudre Valley Health Care Inc CurrentSince Nov 1, 2002 Accepting new patients
Poudre Valley Health Care Inc. CurrentSince Nov 1, 2002 Accepting new patients

Locations

2121 E Harmony Rd
Unit 330
Fort Collins, CO 80528
Phone (970) 221-5878

1939 Wilmington Dr
Unit 102
Fort Collins, CO 80528
Phone (970) 224-2261

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

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 and National Provider Directory roles.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1073540571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 WILMINGTON DR",
            "address_2": "SUITE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805286404",
            "telephone_number": "970-980-6024",
            "fax_number": "877-489-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 WILMINGTON DR",
            "address_2": "SUITE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805286404",
            "telephone_number": "970-980-6024",
            "fax_number": "877-489-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICK",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "37885",
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "CO",
            "license": "37885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32801718",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "636745",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117632300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.