NPIMap

Organization Active NPI

Advanced Healthcare, PLLC

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1124396718
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49380 Issued in CO
Legal business name
ADVANCED HEALTHCARE, PLLC
Practice address
2531 S Shields St Ste 2H
Fort Collins, CO 80526-1857
Phone
(970) 472-8333
Fax
(970) 472-8332
NPI assigned
Dec 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Authorized official

Name
Dr. Nathan M Irwin, D.C.NPI 1841210879
Title
Clinic Director
Phone
(970) 222-7327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 5759 CO
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 49380 CO Primary

Addresses

Primary practice location

2531 S Shields St Ste 2H
Fort Collins, CO 80526-1857

Mailing address

2531 S Shields St Ste 2H
Fort Collins, CO 80526-1857
Phone (970) 472-8333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120726000380 CO Part B Supplier - Clinic/Group Practice 4486810090 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Collins, CO

National Provider Directory

National Provider Directory

Locations

2531 S Shields St
Ste 2H
Fort Collins, CO 80526
Phone (970) 472-8333

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388966400000",
    "number": "1124396718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2531 S SHIELDS ST STE 2H",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261857",
            "telephone_number": "970-472-8333",
            "fax_number": "970-472-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2531 S SHIELDS ST STE 2H",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261857",
            "telephone_number": "970-472-8333",
            "fax_number": "970-472-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "last_updated": "2014-01-06",
        "status": "A",
        "authorized_official_last_name": "IRWIN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "970-222-7327",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CO",
            "license": "5759",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "49380",
            "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 Jan 6, 2014; 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.