Ncap Imh, LLC
Organization Active NPI Anesthesiology Physician · Fort Collins, CO
NPI 1093478075 · NPPES record last updated Oct 18, 2021
Key facts
- NPI
- 1093478075
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 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
- Organization subpart
- No
Authorized official
- Name
- Julie Lease
- Title
- Director Finance and Accounting
- Phone
- (970) 922-3626
Member of 1
Practitioners 45
-
James Alan Derrisaw, M.D.
-
Timothy Edward Kirsch, M.D.
-
Lindsey Ann Lindly, CRNA
-
Joshua Schultz, DNAP, CRNA
-
Benjamin Stephens, CRNA
-
Amy M Wehrman, CRNA
-
Bryan D Dugas, M.D.
-
Kathleen Marie Feeley, CRNA
-
Matthew Alan McGhee, CRNA
-
Richard Donald Alessi, M.D.
-
Ian Scott Anderson, M.D.
-
Kristin Gaines Barney, D.O.
-
Louis Arnold Horton Jr., CRNA
-
Jeremy M. Huff, D.O.
-
Douglas David Krohn, M.D.
-
John Dawson Long III, CRNA
-
William Edward Moss, D.O.
-
Heidi A Reed, CRNA
-
Julio C. Salimbeni, M.D.
-
Paul A Sandoval, MD
-
Gregory James McKinney, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211230000402 | WY | Part B Supplier - Clinic/Group Practice | 2365833340 |
Receives reassigned benefits from 31 practitioners Practice locations: Laramie, WY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes |
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
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.