Edmund Lloyd Blackler, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

56170 Issued in CO

Practice address

2025 Bighorn Rd
Fort Collins, CO 80525-3480

Phone

(970) 229-9800

NPI assigned

Jun 20, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Banner Fort Collins PCP LLC

  • Primary Care Clinic/Center
  • Fort Collins, CO
  • NPI 1831982891

  CO

  Medicare reassignment NPD
• Banner Health Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Greeley, CO
  • NPI 1073899134

  CO

  Medicare reassignment NPD
• VMD Primary Providers Colorado, Inc

  • Primary Care Clinic/Center
  • Fort Collins, CO
  • NPI 1275646614

  CO, Family Medicine

  Medicare reassignment NPD
• Banner Health Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Torrington, WY
  • NPI 1215375688
  NPD
• Banner Fort Collins PCP LLC

  • Multi-Specialty Clinic/Center
  • Fort Collins, CO
  • NPI 1013707207
  NPD (past)
• Colorado State University

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1528156437
  NPD (past)

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1508027632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 BIGHORN RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253480",
            "telephone_number": "970-229-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 BIGHORN RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253480",
            "telephone_number": "970-229-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKLER",
        "first_name": "EDMUND",
        "middle_name": "LLOYD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-10856",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "56170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devon Bjubrey, OT R/L
• Rachel Shannon Black
• Sierra Hope Black
• Keith Blackburn
• Kiera Blackford
• Jennifer Ryan Blackler, PA-C
• Hannah Blackwell, RBT
• Kyle Scott Blackwood, RN
• Stephen L Blad, PHD
• Catherine M Bladow, MSCCCSLP BCBA

• All providers in Fort Collins, CO
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.