NPIMap

Organization Active NPI

Colorado Medical Group, PLLC

Doing business as United Vein & Vascular Centers

  • Vascular Surgery Physician
  • Fort Collins, CO
National Provider Identifier
1467069120
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
COLORADO MEDICAL GROUP, PLLC
Doing business as
United Vein & Vascular Centers
Practice address
3665 John F Kennedy Pkwy Ste 200
Fort Collins, CO 80525-3152
Phone
(800) 991-6117
Fax
(888) 812-8191
NPI assigned
Sep 28, 2020
Last updated
Dec 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Authorized official

Name
Ali N WazniNPI 1154646842
Title
Chief Administration Officer
Phone
(800) 991-6117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

3665 John F Kennedy Pkwy Ste 200
Fort Collins, CO 80525-3152

Mailing address

3810 Northdale Blvd Ste 150
Tampa, FL 33624-1871
Phone (813) 961-1331

Other names 1

  • United Vein & Vascular Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Colorado Medical Group PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5657 S Himalaya St
Ste 210
Centennial, CO 80015

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1467069120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 NORTHDALE BLVD STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241871",
            "telephone_number": "813-961-1331",
            "fax_number": "888-850-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 JOHN F KENNEDY PKWY STE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253152",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "WAZNI",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATION OFFICER",
        "authorized_official_telephone_number": "800-991-6117"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Vein & Vascular Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.