Organization Active NPI

Glow Wellness and Weight Loss Limited

  • Adult Health Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1447047022
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
GLOW WELLNESS AND WEIGHT LOSS LIMITED
Practice address
1136 E Stuart St Ste 4202
Fort Collins, CO 80525-1193
Phone
(970) 690-3309
NPI assigned
Apr 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Authorized official

Name
Stephanie MartinNPI 1912568866
Title
Ceo
Phone
(970) 690-3309

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

1136 E Stuart St Ste 4202
Fort Collins, CO 80525-1193

Mailing address

1136 E Stuart St Ste 4202
Fort Collins, CO 80525-1193

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250717002144 CO Part B Supplier - Clinic/Group Practice 7810402898 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Collins, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1447047022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 E STUART ST STE 4202",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 E STUART ST STE 4202",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251193",
            "telephone_number": "970-690-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOW WELLNESS AND WEIGHT LOSS LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-690-3309"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 17, 2025; 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.