Individual provider Active NPI

Denise Mary Vondra, CAC II

  • Contractor
  • Fort Collins, CO
National Provider Identifier
1114347010
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
0007617 Issued in CO
Practice address
1644 S College Ave
Fort Collins, CO 80525-1007
Phone
(940) 221-0999
NPI assigned
Apr 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 0007617 CO Primary

Addresses

Primary practice location

1644 S College Ave
Fort Collins, CO 80525-1007

Mailing address

1644 S College Ave
Fort Collins, CO 80525-1007
Phone (970) 221-0999

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

LicenseStateTypeSpecialty
0007617COMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1114347010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 S COLLEGE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251007",
            "telephone_number": "970-221-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 S COLLEGE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251007",
            "telephone_number": "940-221-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONDRA",
        "first_name": "DENISE",
        "middle_name": "MARY",
        "credential": "CAC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "CO",
            "license": "0007617",
            "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 Apr 18, 2014; 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.