NPIMap

Individual provider Active NPI

Cheyenne Clayson, PA-C

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1306339197
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6471 Issued in CO
Practice address
3702 S Timberline Rd Ste a
Fort Collins, CO 80525-3625
Phone
(970) 207-9773
NPI assigned
Jun 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6471 CO Primary

Addresses

Primary practice location

3702 S Timberline Rd Ste a
Fort Collins, CO 80525-3625

Mailing address

382 S Arthur Ave
Louisville, CO 80027-3094
Phone (303) 604-5000

Other identifiers 1

IdentifierTypeStateIssuer
9000189693MedicaidCO

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
I20201229001539 CO Practitioner - Physician Assistant 8921354523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3702 S Timberline Rd
Fort Collins, CO 80525-3624

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6471COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Valley Gastroenterology Inc. CurrentSince Dec 11, 2020 Accepting new patients
Boulder Valley Gastroenterology Inc. CurrentSince Dec 11, 2020 Accepting new patients

Locations

1000 W South Boulder Rd
Ste 200
Lafayette, CO 80026
Phone (303) 604-4664

1551 Professional Ln
Unit 290
Longmont, CO 80501

382 S Arthur Ave
Unit 100
Louisville, CO 80027

382 S Arthur Ave
Louisville, CO 80027

Organizations & group practices 3

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1306339197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S ARTHUR AVE",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800273094",
            "telephone_number": "303-604-5000",
            "fax_number": "303-890-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 S TIMBERLINE RD STE A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253625",
            "telephone_number": "970-207-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYSON",
        "first_name": "CHEYENNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "6471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000189693",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.