Organization Active NPI

Allan Douglas Nanney III MD LLC

  • Neurological Surgery Physician
  • Monument, CO
National Provider Identifier
1366040099
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
ALLAN DOUGLAS NANNEY III MD LLC
Practice address
259 Beacon Lite Rd Ste 103
Monument, CO 80132-9110
Phone
(704) 519-9162
NPI assigned
Oct 14, 2020
Last updated
Oct 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Authorized official

Name
Tripp Nanney, MD
Title
Owner/Physician
Phone
(704) 519-9162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

259 Beacon Lite Rd Ste 103
Monument, CO 80132-9110

Mailing address

6653 Lookout Rd # A103
Boulder, CO 80301-3362
Phone (704) 519-9162

Other names 1

  • Tripp Nanney Neurosurgery Other name

National Provider Directory

National Provider Directory

Locations

259 Beacon Lite Rd
Ste 103
Monument, CO 80132
Phone (704) 519-9162

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1366040099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6653 LOOKOUT RD # A103",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013362",
            "telephone_number": "704-519-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 BEACON LITE RD STE 103",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801329110",
            "telephone_number": "704-519-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLAN DOUGLAS NANNEY III MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "NANNEY",
        "authorized_official_first_name": "TRIPP",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "704-519-9162",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tripp Nanney Neurosurgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monument, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.