NPIMap

Organization Active NPI

Banner Health

Doing business as Banner Fort Collins Medical Center

  • Ambulance
  • Fort Collins, CO
National Provider Identifier
1124532924
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
BANNER HEALTH
Doing business as
Banner Fort Collins Medical Center
Practice address
4700 Lady Moon Dr
Fort Collins, CO 80528-4426
Phone
(970) 821-4000
Fax
(970) 821-4501
NPI assigned
Dec 1, 2017
Last updated
Jan 31, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Dennis Laraway
Title
Cfo
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X NU Primary

Addresses

Primary practice location

4700 Lady Moon Dr
Fort Collins, CO 80528-4426

Mailing address

2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702

Other names 1

  • Banner Fort Collins Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Big Horn Family Med28 organizations share this tax ID, including this one
Part of
Big Horn Family Med

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1124532924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N CENTRAL AVE STE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LADY MOON DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805284426",
            "telephone_number": "970-821-4000",
            "fax_number": "970-821-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2017-12-01",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "LARAWAY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Fort Collins Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 31, 2022; 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.