ENT Clinic P.C.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

ENT CLINIC P.C.

Doing business as

Alpha ENT Clinic

Practice address

1032 Luke St
Fort Collins, CO 80524-4037

Phone

(970) 484-8686

Fax

(970) 484-1064

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Melissa Conlon

Title

Practice Administrator

Phone

(970) 484-8686

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alpha ENT Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 3

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

• Meghan Marie Walsh Abraham, AU.D.

  • Audiologist
  • Fort Collins, CO
  • NPI 1811096373
  Medicare reassignment NPD
• William Sean Conlon, M.D.

  • Otolaryngology Physician
  • Fort Collins, CO
  • NPI 1497765812
  Medicare reassignment NPD
• Melanee Lavon Van Ee-Mortensen, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Fort Collins, CO
  • NPI 1144352402
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1235274036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 LUKE ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244037",
            "telephone_number": "970-484-8686",
            "fax_number": "970-484-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 LUKE ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244037",
            "telephone_number": "970-484-8686",
            "fax_number": "970-484-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "CONLON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "970-484-8686"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04008512",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpha ENT Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Courtney Erickson, MSW, LSW, ACC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.