NPIMap

Organization Active NPI

PVHS-Icm Employee Health and Wellness, LLC

  • Clinic/Center
  • Fort Collins, CO
National Provider Identifier
1659704104
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PVHS-ICM EMPLOYEE HEALTH AND WELLNESS, LLC
Practice address
2211 S College Ave
Suite 300
Fort Collins, CO 80525-1489
Phone
(970) 237-6339
Fax
(970) 482-2091
NPI assigned
Aug 19, 2013
Organization subpart
Yes
Parent organization
ASSOCIATES FAMILY MEDICINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Authorized official

Name
Briauna Souders
Title
Manager
Phone
(970) 237-6339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2211 S College Ave
Suite 300
Fort Collins, CO 80525-1489

Mailing address

2211 S College Ave
Suite 300
Fort Collins, CO 80525-1489
Phone (970) 237-6339

National Provider Directory

National Provider Directory
Tax ID family
Columbine3 organizations share this tax ID, including this one
Part of
Assoc in Fam Medicine

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1659704104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 S COLLEGE AVE",
            "address_2": "SUITE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251489",
            "telephone_number": "970-237-6339",
            "fax_number": "970-482-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 S COLLEGE AVE",
            "address_2": "SUITE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251489",
            "telephone_number": "970-237-6339",
            "fax_number": "970-482-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PVHS-ICM EMPLOYEE HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASSOCIATES FAMILY MEDICINE",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "SOUDERS",
        "authorized_official_first_name": "BRIAUNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "970-237-6339"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "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 Aug 19, 2013; 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.