Berthoud Family Physicians

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BERTHOUD FAMILY PHYSICIANS

Practice address

401 10TH St
Berthoud, CO 80513-1381

Phone

(970) 532-4910

NPI assigned

Jun 30, 2006

Organization subpart

Yes

Parent organization

BANNER HEALTHAs reported in NPPES

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

Authorized official

Name

Dennis Dahlen

Title

Sr Vice President Finance

Phone

(602) 747-4000

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

M E Lee MD

Member of 1

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

• Banner Health

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340

  Member Of

  NPD member

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1124056783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 10TH ST",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805131381",
            "telephone_number": "970-532-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTHOUD FAMILY PHYSICIANS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "SR VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04019253",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vicki Baker, P.T.
• Banner Health Physicians Colorado LLC
• Keely Beck
• Carmen Beckwith, D.D.S.
• Berthoud Drug, LLC
• Berthoud Physical Therapy LLC
• Berthoud Physical Therapy LLC
• Gisele Shea Berzins, M.A., L.P.C.
• Big Thompson Medical Group Inc.
• Luke Bishop, D.C.

• Primary Care Clinic/Center in Berthoud, CO
• Providers in Berthoud, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.