NPIMap

Organization Active NPI

Heritage Family Medicine

Doing business as Heritage Senior Care

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1669535118
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36358 Issued in CO
Legal business name
HERITAGE FAMILY MEDICINE
Doing business as
Heritage Senior Care
Practice address
1006 Robertson St
Fort Collins, CO 80524
Phone
(970) 224-1596
Fax
(970) 530-1919
NPI assigned
Dec 18, 2006
Last updated
Jan 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Scott Talbot
Title
Operations Manager
Phone
(970) 224-1596

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 36358 CO Primary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X

Addresses

Primary practice location

1006 Robertson St
Fort Collins, CO 80524

Mailing address

1006 Robertson St
Fort Collins, CO 80524
Phone (970) 224-1596

Other identifiers 1

IdentifierTypeStateIssuer
50773241MedicaidCO

Other names 1

  • Heritage Senior Care Doing business as

National Provider Directory

National Provider Directory

Locations

363 W Drake Rd
Ste 9
Fort Collins, CO 80526
Phone (639) 337-5291

811 E Elizabeth St
Fort Collins, CO 80524
Phone (970) 224-1596

1365 W 29th St
Loveland, CO 80538
Phone (970) 388-3279

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1669535118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 ROBERTSON ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80524",
            "telephone_number": "970-224-1596",
            "fax_number": "970-530-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 ROBERTSON ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80524",
            "telephone_number": "970-224-1596",
            "fax_number": "970-530-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "TALBOT",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "970-224-1596"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "36358",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50773241",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Senior Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 7, 2014; 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.