Nicholas David Shumaker, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

8350 Issued in CO

Practice address

4033 Boardwalk Dr
Suite 100
Fort Collins, CO 80525-5934

Phone

(970) 207-4061

Fax

(970) 207-0051

NPI assigned

Jan 21, 2006

Last updated

Apr 30, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Leslie J. Paris, D.D.S.,M.S.D.,P.C.

  • Periodontics
  • Fort Collins, CO
  • NPI 1881794550
  NPD (past)
• Northern Colorado Periodontics

  • Periodontics
  • Greeley, CO
  • NPI 1437550050
  NPD (past)

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

{
    "created_epoch": "1137801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1619957875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 BOARDWALK DR",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255934",
            "telephone_number": "970-207-4061",
            "fax_number": "970-207-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 BOARDWALK DR",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255934",
            "telephone_number": "970-207-4061",
            "fax_number": "970-207-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAKER",
        "first_name": "NICHOLAS",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-21",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "8350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Shukis, OD
• McKenna Shuler, RBT
• Amy Lynne Shull, MFT
• Lauren Shulman
• Alex James Shulta
• Audrey Shumate
• Pam Sica, M.A., LPC, ATR
• Abby Sickels
• Kourtney Sidener
• Kate Meredith Sidgwick, RD

• Periodontics in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Periodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.