NPIMap

Individual provider Active NPI

Thomas Theodore Heacock, M.D.

  • Pulmonary Disease Physician
  • Fort Collins, CO
National Provider Identifier
1215228473
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
DR.0053921 Issued in CO
Practice address
Uchealth Pulmonology Clinic
2121 E Harmony Road Suite 300
Fort Collins, CO 80528-3403
Phone
(970) 224-9102
Fax
(970) 224-9112
NPI assigned
Apr 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A141859 CA
Pulmonary Disease Physician 207RP1001X DR.0053921 CO Primary

Addresses

Primary practice location

Uchealth Pulmonology Clinic
2121 E Harmony Road Suite 300
Fort Collins, CO 80528-3403

Mailing address

Uchealth Pulmonology Clinic
2121 E Harmony Road Suite 300
Fort Collins, CO 80528-3403
Phone (970) 224-9102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141125000793 CO Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 0840418901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
State University of Ny Upstate Medical University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

4820 Riverbend Rd
Suite 100
Boulder, CO 80301-2618
Phone (303) 415-5399

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A141859CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Pulmonary Disease CurrentSince Oct 14, 2019 Accepting new patients
Poudre Valley Medical Group, LLC Pulmonary Disease Current Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health CurrentSince Jul 22, 2024 Accepting new patients
Boulder Community Health CurrentSince Jul 22, 2024 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

4743 Arapahoe Ave
Ste 201C
Boulder, CO 80303
Phone (303) 442-2150

4820 Riverbend Rd
Ste 100
Boulder, CO 80301
Phone (303) 415-5399

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

101 Erie Pkwy
Ste 201F
Erie, CO 80516
Phone (303) 442-2150

2121 E Harmony Rd
Unit 300
Fort Collins, CO 80528
Phone (970) 224-0429

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1215228473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCHEALTH PULMONOLOGY CLINIC",
            "address_2": "2121 E HARMONY ROAD SUITE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283403",
            "telephone_number": "970-224-9102",
            "fax_number": "970-224-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCHEALTH PULMONOLOGY CLINIC",
            "address_2": "2121 E HARMONY ROAD SUITE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283403",
            "telephone_number": "970-224-9102",
            "fax_number": "970-224-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEACOCK",
        "first_name": "THOMAS",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-22",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A141859",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CO",
            "license": "DR.0053921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.