Fort Collins Pain Treatment Center Inc

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

17195 Issued in CO

Legal business name

FORT COLLINS PAIN TREATMENT CENTER INC

Practice address

1113 Stoney Hill Rd Ste a
Fort Collins, CO 80525-1373

Phone

(970) 221-0565

Fax

(970) 221-0575

NPI assigned

Sep 22, 2008

Organization subpart

No

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

Authorized official

Name

Orrie G Clemens, MD

Title

President

Phone

(970) 221-0565

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2648/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1285884775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 STONEY HILL RD STE A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251373",
            "telephone_number": "970-221-0565",
            "fax_number": "970-221-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 STONEY HILL RD STE A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251373",
            "telephone_number": "970-221-0565",
            "fax_number": "970-221-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT COLLINS PAIN TREATMENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-22",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "ORRIE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-221-0565",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CO",
            "license": "17195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15322564",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Collins Memory Care
• Fort Collins Modern Dentistry, LLP
• Fort Collins Neurology PC
• Fort Collins Oral & Maxillofacial Surgery Partnership
• Fort Collins Orthopaedics PLLC
• Fort Collins Physical Therapy and Sports Center, Inc
• Fort Collins Primary Care PLLC
• Fort Collins Radiologic Associates PC
• Fort Collins Skin Clinic, P.C.
• Fort Collins Spine LLC

• All providers in Fort Collins, CO
• Pain Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.