Active NPI
Timothy Blaylock
- Paramedic
- Fort Collins, CO
National Provider Identifier
1104765254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Paramedic
- License
- 057868
- Practice address
- 2260 W Trilby Rd
Fort Collins, CO 80526-9650 - Phone
- (970) 494-4200
- NPI assigned
- Mar 25, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Paramedic | 146L00000X | 057868 | CO | Primary |
Addresses
Primary practice location
2260 W Trilby Rd
Fort Collins, CO 80526-9650
Mailing address
4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone (970) 494-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057868 | CO | MD | Paramedic |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774396800000",
"number": "1104765254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4856 INNOVATION DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805255539",
"telephone_number": "970-494-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2260 W TRILBY RD",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805269650",
"telephone_number": "970-494-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAYLOCK",
"first_name": "TIMOTHY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-03-25",
"last_updated": "2026-03-25",
"certification_date": "2026-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "146L00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Paramedic",
"state": "CO",
"license": "057868",
"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 Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.