NPIMap

Individual provider Active NPI

Tyler Lynn Davis

  • Gerontology Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1447815295
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APN.0994805-NP Issued in CO
Practice address
2121 E Harmony Rd Unit 170
Fort Collins, CO 80528-3413
Phone
(970) 493-6337
Fax
(970) 493-3528
NPI assigned
May 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.0123492 CO
Gerontology Nurse Practitioner 363LG0600X APN.0994805-NP CO Primary

Addresses

Primary practice location

2121 E Harmony Rd Unit 170
Fort Collins, CO 80528-3413

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071

Other practice location 1

2500 Rocky Mountain Ave Ste 100
Loveland, CO 80538-9004
Phone (970) 624-1800

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
I20190822000077 CO Practitioner - Nurse Practitioner 7012245533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2121 E Harmony Rd
Unit 170 Uchmg Cancer Care and Hem FC
Fort Collins, CO 80528-3413
Phone (970) 493-6337

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.0123492COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 8, 2019 Accepting new patients

Locations

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

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2121 E Harmony Rd
Unit 170
Fort Collins, CO 80528
Phone (970) 493-6337

2121 E Harmony Rd
Unit 100
Fort Collins, CO 80528
Phone (970) 663-3107

6767 29th St
Fl 3
Greeley, CO 80634
Phone (970) 652-2801

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Fl 1
Greeley, CO 80634
Phone (970) 652-2477

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

2500 Rocky Mountain Ave
Ste 2100
Loveland, CO 80538
Phone (970) 203-7153

2500 Rocky Mountain Ave
Ste 100
Loveland, CO 80538
Phone (970) 624-1800

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 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1447815295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD UNIT 170",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283413",
            "telephone_number": "970-493-6337",
            "fax_number": "970-493-3528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Rocky Mountain Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805389004",
            "country_code": "US",
            "telephone_number": "970-624-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TYLER",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0123492",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0994805-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.