NPIMap

Individual provider Active NPI

Adam Stater, AG-ACNP, MSN, RN

  • Acute Care Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1295247393
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APN.0998550-NP Issued in CO
Practice address
2121 E Harmony Rd Unit 160
Fort Collins, CO 80528-3413
Phone
(970) 482-3328
Fax
(970) 482-1433
NPI assigned
Oct 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APN.0998550-NP CO Primary

Addresses

Primary practice location

2121 E Harmony Rd Unit 160
Fort Collins, CO 80528-3413

Mailing address

2121 E Harmony Rd Unit 160
Fort Collins, CO 80528-3413
Phone (970) 482-3328

Other identifiers 1

IdentifierTypeStateIssuer
9000197411MedicaidCO

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
I20211004003344 CO Practitioner - Nurse Practitioner 9931467651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2121 E Harmony Rd
Unit 160 Uchmg Radiation Oncology
Fort Collins, CO 80528-3413
Phone (970) 482-3328

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
APN.0998550-NPCOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 8, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 8, 2024 Accepting new patients

Locations

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

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

2121 E Harmony Rd
Unit 170
Fort Collins, CO 80528
Phone (970) 493-6337

2121 E Harmony Rd
Unit 160
Fort Collins, CO 80528
Phone (970) 482-3328

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 2

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1295247393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD UNIT 160",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283413",
            "telephone_number": "970-482-3328",
            "fax_number": "970-482-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD UNIT 160",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283413",
            "telephone_number": "970-482-3328",
            "fax_number": "970-482-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATER",
        "first_name": "ADAM",
        "credential": "AG-ACNP, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-30",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "APN.0998550-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000197411",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.