Individual provider Active NPI

Angela Sue Walter, MD

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1659338994
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0051591 Issued in CO
Practice address
2950 E Harmony Rd Ste 190
Fort Collins, CO 80528-3430
Phone
(303) 338-4545
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0051591 CO Primary

Addresses

Primary practice location

2950 E Harmony Rd Ste 190
Fort Collins, CO 80528-3430

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other practice location 1

1683 Main St
Windsor, CO 80550-7921
Phone (970) 686-0124

Other identifiers 2

IdentifierTypeStateIssuer
93625715MedicaidCO
023147OtherCOKAISER COMMERCIAL NUMBER

Other names 1

  • Angela Sue Hicks Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121011000317 CO Practitioner - Family Practice 5991719882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Ohio, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

2950 E Harmony Rd
Kaiser Permanente Fort Collins Med
Fort Collins, CO 80528-3419
Phone (303) 338-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0051591COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Colorado, Inc Family Medicine CurrentSince Jun 11, 2019 Accepting new patients
Northwest Ohio Urgent Care Inc Past Accepting new patients

Locations

3519 Richmond Dr
Fort Collins, CO 80526
Phone (970) 204-0300

1300 Riverside Ave
Ste 102
Fort Collins, CO 80524
Phone (970) 224-1670

1683 Main St
Windsor, CO 80550
Phone (970) 400-7618

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1659338994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 E HARMONY RD STE 190",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283430",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1683 Main St",
            "address_purpose": "LOCATION",
            "city": "Windsor",
            "state": "CO",
            "postal_code": "805507921",
            "country_code": "US",
            "telephone_number": "970-686-0124",
            "fax_number": "970-495-6218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTER",
        "first_name": "ANGELA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "0051591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93625715",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "023147",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2950 E Harmony Rd Ste 190",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805283430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "HICKS",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.