Fort Collins Youth Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

FORT COLLINS YOUTH CLINIC

Practice address

1214 Oak Park Dr
Fort Collins, CO 80525-7302

Phone

(970) 267-9510

Fax

(970) 207-9967

NPI assigned

Dec 22, 2020

Organization subpart

No

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

Authorized official

Name

Stephanie Fred

Title

Executive Assistant

Phone

(970) 267-9510

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Fort Collins Youth Clin4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Fort Collins Youth Clinic

  • Pediatrics Physician
  • Timnath, CO
  • NPI 1043807209
  NPD tax ID
• Fort Collins Youth Clinic

  • Pediatrics Physician
  • Fort Collins, CO
  • NPI 1336292622
  NPD tax ID
• Fort Collins Youth Clinic

  • Pediatrics Physician
  • Loveland, CO
  • NPI 1336736594
  NPD tax ID

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1154918308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7328",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370328",
            "telephone_number": "970-663-2742",
            "fax_number": "970-342-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 OAK PARK DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805257302",
            "telephone_number": "970-267-9510",
            "fax_number": "970-207-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT COLLINS YOUTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "FRED",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "970-267-9510"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fort Collins Skin Clinic, P.C.
• Fort Collins Spine LLC
• Fort Collins Spine LLC DME
• Fort Collins Women'S Clinic, P.C.
• Fort Collins Women'S Clinic, PC
• Fort Collins Youth Clinic
• Kristin Fortunski, PT, DPT
• Anna Foster, IBCLC, OTR/L
• Brianne Foster
• Cory Edward Foster, DDS

• Pediatrics Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.