Individual provider Active NPI

David R Marchant, MD

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1376570333
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0039595 Issued in CO
Practice address
1025 Pennock PL
Fort Collins, CO 80524-3257
Phone
(970) 495-8800
Fax
(970) 495-8852
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0039595 CO Primary

Addresses

Primary practice location

1025 Pennock PL
Fort Collins, CO 80524-3257

Mailing address

1025 Pennock PL
Fort Collins, CO 80524-3257
Phone (970) 495-8800

Other identifiers 1

IdentifierTypeStateIssuer
90354770MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000989 CO Practitioner - Family Practice 8921136938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Health Care IncGroup PAC ID 7618880709, 56 clinicians

Practice addresses (Care Compare)

1025 Pennock PL
Fort Collins, CO 80524-3250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0039595COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Health Care Inc. CurrentSince Apr 1, 2002 Accepting new patients
Poudre Valley Health Care Inc CurrentSince Apr 1, 2002 Accepting new patients
Poudre Valley Health Care,Inc Past Accepting new patients

Locations

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

1025 Pennock Pl
Ste 121
Fort Collins, CO 80524
Phone (970) 495-8800

2315 E Harmony Rd
Ste 200
Fort Collins, CO 80528

1025 Pennock Pl
#111
Fort Collins, CO 80524

1025 Pennock Pl
Ste 114
Fort Collins, CO 80524
Phone (970) 495-8800

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1376570333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHANT",
        "first_name": "DAVID",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0039595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90354770",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.