NPIMap

Individual provider Active NPI

Amber R Knuthson, PA-C

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1366700056
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3393 Issued in CO
Practice address
2121 E Harmony Rd
Suite 160
Fort Collins, CO 80528-3400
Phone
(970) 482-3328
Fax
(970) 482-1433
NPI assigned
May 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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 3393 CO Primary

Addresses

Primary practice location

2121 E Harmony Rd
Suite 160
Fort Collins, CO 80528-3400

Mailing address

2121 E Harmony Rd
Suite 160
Fort Collins, CO 80528-3400
Phone (970) 482-3328

Other identifiers 1

IdentifierTypeStateIssuer
32279825MedicaidCO

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
I20120725000057 CO Practitioner - Physician Assistant 5890951586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Fort Collins, CO 80524-3929

2121 E Harmony Rd
Fort Collins, CO 80528-3413

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3393COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Oct 3, 2013 Accepting new patients

Locations

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

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

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 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": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1366700056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD",
            "address_2": "SUITE 160",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283400",
            "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",
            "address_2": "SUITE 160",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283400",
            "telephone_number": "970-482-3328",
            "fax_number": "970-482-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTHSON",
        "first_name": "AMBER",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32279825",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.