Active NPI
Ethan Montrose
- Behavior Technician
- Fort Collins, CO
National Provider Identifier
1609550284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3500 John F Kennedy Pkwy Ste B2
Fort Collins, CO 80525-2635 - Phone
- (720) 295-3790
- NPI assigned
- Jun 14, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | CO | Primary |
Addresses
Primary practice location
3500 John F Kennedy Pkwy Ste B2
Fort Collins, CO 80525-2635
Mailing address
15654 Elizabeth St
Thornton, CO 80602-7729
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686700800000",
"number": "1609550284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15654 ELIZABETH ST",
"city": "THORNTON",
"state": "CO",
"postal_code": "806027729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 JOHN F KENNEDY PKWY STE B2",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805252635",
"telephone_number": "720-295-3790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTROSE",
"first_name": "ETHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-14",
"last_updated": "2023-06-14",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CO",
"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 Jun 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.