NPIMap

Organization Active NPI

Ncap Imh, LLC

  • Anesthesiology Physician
  • Fort Collins, CO
National Provider Identifier
1093478075
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NCAP IMH, LLC
Practice address
3702 Automation Way Ste 103
Fort Collins, CO 80525-5738
Phone
(970) 922-3626
NPI assigned
Oct 18, 2021
Last updated
Oct 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Authorized official

Name
Julie Lease
Title
Director Finance and Accounting
Phone
(970) 922-3626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

3702 Automation Way Ste 103
Fort Collins, CO 80525-5738

Mailing address

3702 Automation Way Ste 103
Fort Collins, CO 80525-5738

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211230000402 WY Part B Supplier - Clinic/Group Practice 2365833340 Receives reassigned benefits from 31 practitioners
Practice locations: Laramie, WY

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1093478075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY STE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY STE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255738",
            "telephone_number": "970-922-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NCAP IMH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "LEASE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "DIRECTOR FINANCE AND ACCOUNTING",
        "authorized_official_telephone_number": "970-922-3626"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 18, 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.