Banner Health Physicians Colorado LLC

Organization Active NPI Multi-Specialty Clinic/Center · Loveland, CO

NPI 1134483472 · NPPES record last updated Feb 11, 2022

Key facts

NPI: 1134483472
Entity type: Organization (NPI type 2)
Primary specialty: Multi-Specialty Clinic/Center 261QM1300X
Legal business name: BANNER HEALTH PHYSICIANS COLORADO LLC
Practice address: 2555 E 13TH St Ste 100
Loveland, CO 80537-5134
Phone: (970) 613-1745
Fax: (970) 461-6160
NPI assigned: Jul 2, 2012
Organization subpart: Yes
Parent organization (as reported): BANNER MEDICAL GROUP COLORADO

Authorized official

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

Practitioners 3

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

Adam D Mackintosh, DO Family Medicine Physician · Sterling, CO · NPI 1992721013

NPD
Karla Dawn Ornelas, FNP Nurse Practitioner · Greeley, CO · NPI 1023321981

NPD
Jennifer L Van Horn, AOCNS Primary Care Nurse Practitioner · Loveland, CO · NPI 1023386919

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CO

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20111219000237	CO	Part B Supplier - Clinic/Group Practice	8921273038	Receives reassigned benefits from 380 practitioners This NPI is an additional NPI on the enrollment Practice locations: Loveland, CO; Yuma, CO; Sterling, CO; Timnath, CO; Wellington, CO; Windsor, CO; Wray, CO; Fort Collins, CO…

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Multi-Specialty Clinic/Center	261QM1300X			Yes

Addresses

Primary practice location

2555 E 13TH St Ste 100
Loveland, CO 80537-5134

Mailing address

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

Other providers in Loveland, CO

All providers in Loveland, CO · Multi-Specialty Clinic/Center in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.