Individual provider Active NPI

Amanda Halverson, CRNA, DNAP

  • Certified Registered Nurse Anesthetist
  • Fort Collins, CO
National Provider Identifier
1346872199
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0995376 Issued in CO
Practice address
3702 Automation Way Ste 103
Fort Collins, CO 80525-5738
Phone
(970) 922-3622
NPI assigned
Feb 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0995376 CO Primary

Addresses

Primary practice location

3702 Automation Way Ste 103
Fort Collins, CO 80525-5738

Mailing address

3702 Automation Way Ste 103
Fort Collins, CO 80525-5738
Phone (970) 922-3622

Other names 1

  • Amanda Black Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200505000516 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911338090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Colorado Anesthesia Professionals PLLCGroup PAC ID 6800878760, 155 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Ncap PLLC
Fort Collins, CO 80524-3929
Phone (970) 495-7000

2500 E Prospect Rd
Ncap PLLC
Fort Collins, CO 80525-9718
Phone (970) 493-0112

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-2985

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
0995376COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Colorado Anesthesia Professionals PLLC CurrentSince May 1, 2020 Accepting new patients

Locations

3702 Automation Way
Ste 103
Fort Collins, CO 80525
Phone (970) 922-3622

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

Organizations & group practices 1

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": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1346872199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY STE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255738",
            "telephone_number": "970-922-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY STE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255738",
            "telephone_number": "970-922-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVERSON",
        "first_name": "AMANDA",
        "credential": "CRNA, DNAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "0995376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BLACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.