Individual provider Active NPI

Barbara Widom, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Collins, CO
National Provider Identifier
1669480810
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
32251 Issued in CO
Practice address
1106 E Prospect Rd
Suite 100
Fort Collins, CO 80525-5306
Phone
(970) 224-3636
Fax
(970) 224-3637
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32251 CO
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 32251 CO Primary

Addresses

Primary practice location

1106 E Prospect Rd
Suite 100
Fort Collins, CO 80525-5306

Mailing address

1106 E Prospect Rd
Suite 100
Fort Collins, CO 80525-5304
Phone (970) 224-3636

Other identifiers 3

IdentifierTypeStateIssuer
01322510MedicaidCO
P00970408OtherCORAILROAD MEDICARE
P00431825OtherCORAILROAD MEDICARE

Other names 1

  • Barbara Wilson Former name

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
I20070723000422 CO Practitioner - EndocrinologyPractitioner - Internal Medicine 1557462470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Columbia University College of Physicians and Surgeons, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

2121 E Harmony Rd
Fort Collins, CO 80528-3401

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Ivinson Memorial Hospital Hospital, Laramie, WY, CCN 530025
  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131
  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32251COMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Feb 1, 2011 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 1, 2011 Accepting new patients
Northern Colorado Pulmonary Consutlants, PC Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1040 E Elizabeth St
Unit B
Fort Collins, CO 80524
Phone (970) 224-3636

1106 E Prospect Rd
Ste 100
Fort Collins, CO 80525
Phone (970) 224-3636

2121 E Harmony Rd
Unit 230
Fort Collins, CO 80528
Phone (970) 266-8822

2121 E Harmony Rd
Unit 300
Fort Collins, CO 80528
Phone (970) 224-0429

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

221 E 29th St
Ste 102
Loveland, CO 80538
Phone (970) 224-3636

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

2500 Rocky Mountain Ave
Ste 330
Loveland, CO 80538
Phone (970) 203-7110

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1669480810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 E PROSPECT RD",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255304",
            "telephone_number": "970-224-3636",
            "fax_number": "970-224-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 E PROSPECT RD",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255306",
            "telephone_number": "970-224-3636",
            "fax_number": "970-224-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDOM",
        "first_name": "BARBARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "32251",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CO",
            "license": "32251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01322510",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00970408",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00431825",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BARBARA",
            "last_name": "WILSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.