Clinton Lee Hartman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0000483 Issued in CO

Practice address

1025 Pennock PL Ste 121
Fort Collins, CO 80524-3257

Phone

(980) 495-8980

Fax

(970) 495-8988

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1346335577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL STE 121",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "980-495-8980",
            "fax_number": "970-495-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL STE 121",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "980-495-8980",
            "fax_number": "970-495-8988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2127 E Harmony Rd",
            "address_2": "Suite 140",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805283405",
            "country_code": "US",
            "telephone_number": "970-297-6250",
            "fax_number": "970-297-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "CLINTON",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0000483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17208548",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Hart, PT, DPT
• Jennifer Lynn Hart, CRNA
• Madison Hart
• Elizabeth Layne Hartley, LPCC
• Susan E. Hartley, R.N.
• Kristin Hartman, MA, LPCC
• Nathan Hartman, MA, LPC
• Ryan L Hartman, MD
• Hartshorn Health Center
• Hartshorn Health Service

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.