Bender Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

32679 Issued in CO

Legal business name

BENDER MEDICAL GROUP INC

Doing business as

Miramont Family Medicine

Practice address

4674 Snow Mesa Dr
Ste 140
Ft Collins, CO 80528

Phone

(970) 482-0213

Fax

(970) 482-9646

NPI assigned

Oct 13, 2006

Last updated

Mar 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Teresa E Bender

Title

Practice Admin

Phone

(970) 482-0213

Specialties & licenses 13

Addresses

Other identifiers 2

Other names 1

• Miramont Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Lumir Bender, M.D.

  • Family Medicine Physician
  • Fort Collins, CO
  • NPI 1609864065
  Medicare reassignment Care Compare group NPD
• Samantha Elizabeth Davis, FNP-C

  • Family Nurse Practitioner
  • Fort Collins, CO
  • NPI 1346361599
  Medicare reassignment Care Compare group NPD
• Charlie A. Dickman, MD

  • Family Medicine Physician
  • Parker, CO
  • NPI 1205832433
  Medicare reassignment Care Compare group NPD
• Prema M Jacob, MD

  • Family Medicine Physician
  • Loveland, CO
  • NPI 1487633533
  Medicare reassignment Care Compare group NPD
• Angela Michelle Blevins, PA-C

  • Family Medicine Physician
  • Parker, CO
  • NPI 1902564388
  Medicare reassignment Care Compare group
• Kira Miklos, PA-C

  • Physician Assistant
  • Englewood, CO
  • NPI 1467165050
  Medicare reassignment Care Compare group
• Ray M Quenneville, PA

  • Physician Assistant
  • Fort Collins, CO
  • NPI 1730153875
  Medicare reassignment Care Compare group
• Julie M Deters, FNP

  • Family Nurse Practitioner
  • Loveland, CO
  • NPI 1861713075
  Medicare reassignment NPD
• Douglas Bruce Deyoung, DO

  • Family Medicine Physician
  • Fort Collins, CO
  • NPI 1811989064
  Medicare reassignment NPD
• Carolynn Starr Francavilla Brown, MD

  • Family Medicine Physician
  • Lakewood, CO
  • NPI 1568753739
  Medicare reassignment NPD
• Lisa M Hammond, NP-C

  • Primary Care Nurse Practitioner
  • Parker, CO
  • NPI 1124360771
  Medicare reassignment NPD
• Kelly H Lowther, MD

  • Obesity Medicine (Family Medicine) Physician
  • Denver, CO
  • NPI 1871666172
  Medicare reassignment NPD

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1215027107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "STE 140",
            "city": "FT COLLINS",
            "state": "CO",
            "postal_code": "80528",
            "telephone_number": "970-482-0213",
            "fax_number": "970-482-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "STE 140",
            "city": "FT COLLINS",
            "state": "CO",
            "postal_code": "80528",
            "telephone_number": "970-482-0213",
            "fax_number": "970-482-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENDER MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "BENDER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE ADMIN",
        "authorized_official_telephone_number": "970-482-0213",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "32679",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "42203",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "45095",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "27536",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "40384",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "21180",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "31325",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "46447",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1082",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "905",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2790",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2589",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "NP10339",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "654282",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19930054",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miramont Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bender Medical Group
• Bender Medical Group (Miramont Family Medicine)
• Bender Medical Group (Miramont Family Medicine)
• Bender Medical Group (Miramont Family Medicine)
• Bender Medical Group (Miramont Family Medicine)
• Bender Medical Group, Inc (Miramont Dental Hygiene)
• Bender Medical Group, Inc (Miramont Family Medicine)
• John Lumir Bender, M.D.
• Brianna Hope Bendixsen, M.A.
• Cheryl E Benedetto, LPC

• Family Medicine Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.