Advanced Neurology of Colorado, LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

ADVANCED NEUROLOGY OF COLORADO, LLC

Practice address

1551 Professional LN Unit 125
Longmont, CO 80501-6971

Phone

(970) 226-6111

Fax

(970) 226-6707

NPI assigned

Sep 6, 2022

Last updated

Sep 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Michael Miller

Title

Site Manager

Phone

(970) 227-6333

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Advanced Neurology of Colorado, LLC

  • Specialist
  • Fort Collins, CO
  • NPI 1972556991

  O20031209000085

  Same enrollment

Practitioners 9

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.

• Sidarth Dasari

  • Neurology Physician
  • Boulder, CO
  • NPI 1497286421
  NPD
• Kimberly Eisenbach, FNP-BC, AGACNP-BC

  • Nurse Practitioner
  • Johnstown, CO
  • NPI 1811414295
  NPD
• Elijah Austin Lackey, MD

  • Neurology Physician
  • Fort Collins, CO
  • NPI 1821594219
  NPD
• Benjamin Miceli, PA-C

  • Physician Assistant
  • Fort Collins, CO
  • NPI 1043633324
  NPD
• Colleen Elizabeth Wallace, PA-C

  • Physician Assistant
  • Longmont, CO
  • NPI 1568187904
  NPD
• Courtney Weir, NP

  • Family Nurse Practitioner
  • Johnstown, CO
  • NPI 1437661170
  NPD
• Ning Sarah Yang

  • Neurology Physician
  • Johnstown, CO
  • NPI 1275809675
  NPD
• Sheri J Friedman, MD

  • Neurology Physician
  • Loveland, CO
  • NPI 1285645986
  NPD (past)
• Richard E Popwell Jr., M.D.

  • Neurology Physician
  • Bozeman, MT
  • NPI 1699721746
  NPD (past)

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1386365641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD UNIT 180",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283401",
            "telephone_number": "970-226-6705",
            "fax_number": "970-226-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LN UNIT 125",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016971",
            "telephone_number": "970-226-6111",
            "fax_number": "970-226-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED NEUROLOGY OF COLORADO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SITE MANAGER",
        "authorized_official_telephone_number": "970-227-6333"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00609048",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Addiction Treatment Center of Longmont
• Jillian Elizabeth Adkins
• Ma. Grace P Adler
• Mary C Adler, CERT PED NURSE PRACT
• Adrienne M. Hedrick, DDS,PC
• Advanced Urology, PLLC
• Advanced Vision Surgery Center LLC
• Affinity Home Health Care
• Affirmative Care, P.C. (True U Clinic)
• After Baby Care Doula

• Neurology Physician in Longmont, CO
• Providers in Longmont, CO by specialty
• Neurology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.