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Organization Active NPI Primary Care Clinic/Center · Fort Collins, CO

NPI 1225828403 · NPPES record last updated Jul 30, 2025

Key facts

NPI
1225828403
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
Legal business name
BANNER FORT COLLINS PCP LLC
Practice address
2001 S Shields St BLDG 1
Fort Collins, CO 80526-1827
Phone
(970) 449-0352
NPI assigned
May 9, 2025
Organization subpart
Yes
Parent organization (as reported)
BANNER MEDICAL GROUP LLC

Authorized official

Name
Shiva Birdi, MD
Title
Ceo
Phone
(602) 747-4000

Corporate family (same tax ID) 45

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

View all 45

National Provider Directory

Tax ID family
Banner Health Physicians (46 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X Yes

Addresses

Primary practice location

2001 S Shields St BLDG 1
Fort Collins, CO 80526-1827

Mailing address

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

Other providers in Fort Collins, CO

All providers in Fort Collins, CO · Primary Care Clinic/Center in Colorado

Sources for this page

Verify at the official NPI Registry.